Provider Demographics
NPI:1134458623
Name:LABORATORIO DSM RUM
Entity Type:Organization
Organization Name:LABORATORIO DSM RUM
Other - Org Name:DEPARTAMENTO DE SERVICIOS MEDICOS RUM
Other - Org Type:Other Name
Authorized Official - Title/Position:CHANCELLOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:I
Authorized Official - Last Name:RIVERA SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-832-4040
Mailing Address - Street 1:PO BOX 9039
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-9039
Mailing Address - Country:US
Mailing Address - Phone:787-265-3865
Mailing Address - Fax:787-834-3031
Practice Address - Street 1:259 ALFONSO VALDES BLVD. RUM
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00681
Practice Address - Country:US
Practice Address - Phone:787-265-3865
Practice Address - Fax:787-834-3031
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RECINTO UNIVERSITARIO DE MAYAGUEZ
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR330291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory