Provider Demographics
NPI:1528588274
Name:MIGRANT HEALTH CENTER WESTERN REGION, INC.
Entity Type:Organization
Organization Name:MIGRANT HEALTH CENTER WESTERN REGION, INC.
Other - Org Name:MIGRANT HEALTH CENTER WESTERN REGION, INC. LABORATORIO YAUCO
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTORA EJECUTIVA
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-833-5890
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-0190
Mailing Address - Country:US
Mailing Address - Phone:787-833-5890
Mailing Address - Fax:787-834-1924
Practice Address - Street 1:CARRETERA 128 KM 4.1
Practice Address - Street 2:BO ALMACIGO BAJO
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-0000
Practice Address - Country:US
Practice Address - Phone:787-856-8449
Practice Address - Fax:787-834-1924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-23
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1363291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory