Provider Demographics
NPI:1144208216
Name:QUIMED CORP
Entity Type:Organization
Organization Name:QUIMED CORP
Other - Org Name:LABORATORIO CLINICO QUIMICO QUIMED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DUENA
Authorized Official - Prefix:
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:I
Authorized Official - Last Name:PACHECO RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MT MS
Authorized Official - Phone:787-726-0397
Mailing Address - Street 1:PO BOX 7056
Mailing Address - Street 2:AVENIDA BORINQUEN 2036 BO. OBRERO SANTURCE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00916-7056
Mailing Address - Country:US
Mailing Address - Phone:787-726-0397
Mailing Address - Fax:787-726-0397
Practice Address - Street 1:AVE BORINQUEN 2036 BO OBRERO SANTURCE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00915
Practice Address - Country:US
Practice Address - Phone:787-726-0397
Practice Address - Fax:787-726-0397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
291U00000X
PR559291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0038102Medicare PIN
0038102Medicare ID - Type Unspecified