Provider Demographics
NPI:1497318364
Name:PRIMARY HEALTH CENTER, PSC
Entity Type:Organization
Organization Name:PRIMARY HEALTH CENTER, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOURDES
Authorized Official - Middle Name:MERCADO
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-675-0754
Mailing Address - Street 1:PO BOX 117
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-0117
Mailing Address - Country:US
Mailing Address - Phone:787-818-2866
Mailing Address - Fax:787-551-7038
Practice Address - Street 1:154 CALLE BARBOSA
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-818-2866
Practice Address - Fax:787-551-7038
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRIMARY HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-17
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty