Provider Demographics
NPI:1821660432
Name:PHYSICIAN MANAGEMENT CORPORATION OF AMERICA
Entity Type:Organization
Organization Name:PHYSICIAN MANAGEMENT CORPORATION OF AMERICA
Other - Org Name:ME BY MEDPLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SULTAN
Authorized Official - Middle Name:SALEH
Authorized Official - Last Name:YASSIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:787-523-2900
Mailing Address - Street 1:PO BOX 364109
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4109
Mailing Address - Country:US
Mailing Address - Phone:787-523-2900
Mailing Address - Fax:
Practice Address - Street 1:282 AVE JESUS T PINERO STE 200
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-3921
Practice Address - Country:US
Practice Address - Phone:787-523-2900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ME BY MEDPLUS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy