Provider Demographics
NPI:1902825391
Name:TOA ALTA CURA CHC
Entity Type:Organization
Organization Name:TOA ALTA CURA CHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:VEGA
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-870-1529
Mailing Address - Street 1:16 CALLE BARCELO
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-2444
Mailing Address - Country:US
Mailing Address - Phone:787-870-1529
Mailing Address - Fax:787-870-1508
Practice Address - Street 1:16 CALLE BARCELO
Practice Address - Street 2:
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-2444
Practice Address - Country:US
Practice Address - Phone:787-870-1529
Practice Address - Fax:787-870-1508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0706291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR31360OtherTRIPLE S TRIPLE C
PRP848OtherINTERNATIONAL MED CARD
PR3451-3OtherASOCIACION DE MAESTROS
PR4001281OtherACAA
PR00424OtherAMERICAN HEALTH
PR100167OtherCRUZ AZUL DE PUERTO RICO
PR600293OtherPREFERRED HEALTH PLAN
PR0706OtherSTATE LABORATORY LICENSE
PR61OtherSTATE HEALTH LICENSE
PR3451-3OtherASOCIACION DE MAESTROS
PR4001281OtherACAA