Provider Demographics
NPI:1518375625
Name:SERVICIOS DE SALUD PRIMARIOS DE BARCELONETA, INC.
Entity Type:Organization
Organization Name:SERVICIOS DE SALUD PRIMARIOS DE BARCELONETA, INC.
Other - Org Name:SERVICIOS DE SALUD DE BARCELONETA
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LEIDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:NAZARIO
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-846-4412
Mailing Address - Street 1:PO BOX 2045
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-2045
Mailing Address - Country:US
Mailing Address - Phone:787-846-4412
Mailing Address - Fax:787-846-7410
Practice Address - Street 1:CARR 639 KM 2.0
Practice Address - Street 2:SABANA HOYOS
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-846-4412
Practice Address - Fax:787-846-4412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-01
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health