Provider Demographics
NPI:1659940401
Name:JS MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:JS MEDICAL SERVICES LLC
Other - Org Name:JS MEDICAL SERVICES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-483-7153
Mailing Address - Street 1:PO BOX 10258
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-1258
Mailing Address - Country:US
Mailing Address - Phone:787-483-7150
Mailing Address - Fax:787-483-7147
Practice Address - Street 1:100 AVE FONT MARTELO W
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3923
Practice Address - Country:US
Practice Address - Phone:787-483-7153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JS MEDICAL SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-24
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR012345Other012345