Provider Demographics
NPI:1710445598
Name:PREVENTION MEDICAL SERVICES PSC
Entity Type:Organization
Organization Name:PREVENTION MEDICAL SERVICES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ARIEL
Authorized Official - Last Name:BADILLO-HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-658-7098
Mailing Address - Street 1:PO BOX 1198
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-1198
Mailing Address - Country:US
Mailing Address - Phone:787-658-7098
Mailing Address - Fax:866-400-3604
Practice Address - Street 1:CARR 2 KM 127.4 EDIF PUNTO ORO
Practice Address - Street 2:SUITE 9
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-658-7098
Practice Address - Fax:866-400-3604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty