Provider Demographics
NPI:1891907101
Name:EMPRESAS HERNANDEZ MERCADO INC
Entity Type:Organization
Organization Name:EMPRESAS HERNANDEZ MERCADO INC
Other - Org Name:LAB DR CORDOVA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL TECHNOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCADO HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-765-3735
Mailing Address - Street 1:1055 CALLE BRUMBAUGH
Mailing Address - Street 2:
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00925-2916
Mailing Address - Country:US
Mailing Address - Phone:787-765-3735
Mailing Address - Fax:787-765-3735
Practice Address - Street 1:1055 CALLE BRUMBAUGH
Practice Address - Street 2:
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00925-2916
Practice Address - Country:US
Practice Address - Phone:787-765-3735
Practice Address - Fax:787-765-3735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR144291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR38007Medicare PIN