Provider Demographics
NPI:1194030296
Name:SERVIMED ABSOLUTE CARE - CAP, INC.
Entity Type:Organization
Organization Name:SERVIMED ABSOLUTE CARE - CAP, INC.
Other - Org Name:SAC-CAP
Other - Org Type:Other Name
Authorized Official - Title/Position:MAIN EXECUTIVE
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:G
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-882-5705
Mailing Address - Street 1:PO BOX 5264
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-5264
Mailing Address - Country:US
Mailing Address - Phone:787-882-5705
Mailing Address - Fax:787-891-6976
Practice Address - Street 1:AVE NATIVO ALERS EDIF QUINONES GONZALEZ
Practice Address - Street 2:SEGUNDO PISO OFICINA #5
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-882-5705
Practice Address - Fax:787-891-6976
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COOPERATIVA DE SERVICIOS MEDICOS DE PR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization