Provider Demographics
NPI:1922257666
Name:NORTHWEST PRIMARY HEALTHCARE CENTER, PSC
Entity Type:Organization
Organization Name:NORTHWEST PRIMARY HEALTHCARE CENTER, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ-GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-890-0789
Mailing Address - Street 1:HC 07 BOX 38931
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-9466
Mailing Address - Country:US
Mailing Address - Phone:787-890-0789
Mailing Address - Fax:787-890-0789
Practice Address - Street 1:CARR. 110 KM 3.6
Practice Address - Street 2:BO. ARENALES
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-9466
Practice Address - Country:US
Practice Address - Phone:787-890-0789
Practice Address - Fax:787-890-0789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5250261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care