Organization Name: | PRIME MEDICA PSC |
NPI Number: | 1215340567 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HIRAM J ORTEGA (PRESIDENT) |
Mailing Address: | Hc 3 Box 39603 Aguada |
State: | PR US |
Postal Code: | 006029794 |
Phone Number: | 7878680345 |
Fax Number: | 7878680345 |
NPI Enumeration Date: | 06/04/2014 |
NPI Last Update Date: | 06/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |