Provider Demographics
NPI:1346944352
Name:HPM FOUNDATION CLINICAL LABORATORY
Entity Type:Organization
Organization Name:HPM FOUNDATION CLINICAL LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:IVONNE
Authorized Official - Middle Name:I
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-268-4171
Mailing Address - Street 1:PO BOX 14457
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00916-4457
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CALLE BENITEZ GUZMAN NUM 47
Practice Address - Street 2:ISABEL II BO: PUEBLO
Practice Address - City:VIEQUES
Practice Address - State:PR
Practice Address - Zip Code:00765-9998
Practice Address - Country:US
Practice Address - Phone:787-468-2000
Practice Address - Fax:787-919-3956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory