Provider Demographics
NPI:1629447479
Name:BETTER CHOICE LABORATORIES CORP
Entity Type:Organization
Organization Name:BETTER CHOICE LABORATORIES CORP
Other - Org Name:CDT CANOVANAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:CECILIA
Authorized Official - Last Name:MOJICA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-908-8118
Mailing Address - Street 1:PO BOX 2003
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-2003
Mailing Address - Country:US
Mailing Address - Phone:787-876-5000
Mailing Address - Fax:787-886-2203
Practice Address - Street 1:CALLE CORCHADO FINAL
Practice Address - Street 2:CDT CANOVANAS
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-876-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR961291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory