Provider Demographics
NPI:1467507707
Name:PPMI-RCM
Entity Type:Organization
Organization Name:PPMI-RCM
Other - Org Name:RCM-LABORATORIO CLINICO SERVICIOS MEDICOS UNVERSITARIOS
Other - Org Type:Other Name
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TROCHE
Authorized Official - Suffix:
Authorized Official - Credentials:RHIA
Authorized Official - Phone:787-758-2525
Mailing Address - Street 1:PO BOX 29134
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0134
Mailing Address - Country:US
Mailing Address - Phone:787-758-2525
Mailing Address - Fax:787-274-8156
Practice Address - Street 1:CENTRO MEDICO DE PR
Practice Address - Street 2:EDF. PRINCIPAL ESCUELA DE MEDICINA APTDO.29134
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00929-0134
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:787-274-8156
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ESCUELA DE MEDICINA-UPR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-25
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR36OtherPPMI GROUP
PR36OtherPPMI GROUP