Provider Demographics
NPI:1619508769
Name:SMART BUSINESS GROUP
Entity Type:Organization
Organization Name:SMART BUSINESS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:787-929-6779
Mailing Address - Street 1:PO BOX 2427
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-2427
Mailing Address - Country:US
Mailing Address - Phone:787-929-6779
Mailing Address - Fax:
Practice Address - Street 1:PR-3 KM 152.1
Practice Address - Street 2:BDA. LOPEZ PARCEL 10
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751
Practice Address - Country:US
Practice Address - Phone:787-929-6779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SMART BUSINESS GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health