Organization Name: | CENTRO DE VACUNACION DEL NOROESTE, INC. |
NPI Number: | 1316163843 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FUAD S. ALBA (PRESIDENTE) |
Mailing Address: | Lirio F-3 Bzn.27 Urb. Vistas De San Loenzo San Lorenzo |
State: | PR US |
Postal Code: | 00754 |
Phone Number: | 7877367539 |
Fax Number: | 7877367539 |
NPI Enumeration Date: | 04/17/2007 |
NPI Last Update Date: | 08/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QV0200X |
License Number: | 1134 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | VA |
Taxonomy Definition: |