Provider Demographics
NPI:1194372300
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:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:LEGARRETA
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:787-262-3984
Practice Address - Street 1:78 CALLE DR CUETO
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641-0065
Practice Address - Country:US
Practice Address - Phone:787-680-2019
Practice Address - Fax:787-262-3984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy