Provider Demographics
NPI:1821394123
Name:IPAS DEL NORESTE INC.
Entity Type:Organization
Organization Name:IPAS DEL NORESTE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-887-0020
Mailing Address - Street 1:PO BOX 1515
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-1515
Mailing Address - Country:US
Mailing Address - Phone:787-887-0020
Mailing Address - Fax:787-887-0020
Practice Address - Street 1:J2 CALLE 2
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745-2840
Practice Address - Country:US
Practice Address - Phone:787-887-0020
Practice Address - Fax:787-887-0020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization