Provider Demographics
NPI:1417125261
Name:MILLENIUM MEDICAL CONSULTING SERVICES, PSC
Entity Type:Organization
Organization Name:MILLENIUM MEDICAL CONSULTING SERVICES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:CACHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-473-7108
Mailing Address - Street 1:C 18 MARGINAL
Mailing Address - Street 2:CALLE STA CRUZ
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-473-7108
Mailing Address - Fax:
Practice Address - Street 1:C 18 MARGINAL
Practice Address - Street 2:CALLE STA CRUZ
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-473-7108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization