Provider Demographics
NPI:1689655144
Name:AMMVR GROUP, INC
Entity Type:Organization
Organization Name:AMMVR GROUP, INC
Other - Org Name:IMRL CLINICAL LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR FINANZAS
Authorized Official - Prefix:MR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-999-2990
Mailing Address - Street 1:PO BOX 195519
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-5519
Mailing Address - Country:US
Mailing Address - Phone:787-999-2990
Mailing Address - Fax:787-764-8809
Practice Address - Street 1:283 AVE DOMENECH
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3520
Practice Address - Country:US
Practice Address - Phone:787-765-0807
Practice Address - Fax:787-753-4453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR972291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR31354Medicare ID - Type Unspecified