Provider Demographics
NPI:1083028997
Name:METRO PAVIA AT HOME LLC
Entity Type:Organization
Organization Name:METRO PAVIA AT HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL OFICIAL DE OPERACIONES
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:N
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:787-999-8941
Mailing Address - Street 1:PO BOX 11938
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-1938
Mailing Address - Country:US
Mailing Address - Phone:787-999-8941
Mailing Address - Fax:
Practice Address - Street 1:1785 CARR 21
Practice Address - Street 2:URB LAS LOMAS
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00925
Practice Address - Country:US
Practice Address - Phone:787-782-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health