Provider Demographics
NPI:1932110053
Name:HEALTH ADMIN SVC INC
Entity Type:Organization
Organization Name:HEALTH ADMIN SVC INC
Other - Org Name:FARMACIA SNF LA CASA DEL VETERANO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JERGE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAOLI BRUNO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-381-0247
Mailing Address - Street 1:PO BOX 194288
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-4288
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CARR 592 NUM 15 BO AMUELAS
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-2872
Practice Address - Country:US
Practice Address - Phone:787-837-6574
Practice Address - Fax:787-260-0034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0002X, 3336I0012X, 3336L0003X, 3336S0011X
PR07F21563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4025195OtherNCPDP PROVIDER IDENTIFICATION NUMBER