Provider Demographics
NPI:1093475675
Name:CORPORACION DE SERVICIOS MEDICOS PRIMARIOS Y PREVENCION DE HATILLO
Entity Type:Organization
Organization Name:CORPORACION DE SERVICIOS MEDICOS PRIMARIOS Y PREVENCION DE HATILLO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:D
Authorized Official - Last Name:TORRES MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-898-4190
Mailing Address - Street 1:PO BOX 907
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-0907
Mailing Address - Country:US
Mailing Address - Phone:787-898-4190
Mailing Address - Fax:
Practice Address - Street 1:CALLE ANTONIO R BARCELO # 5
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641
Practice Address - Country:US
Practice Address - Phone:787-898-4190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)