Provider Demographics
NPI:1952310740
Name:MEDICAL PHARMACY & LABORATORY ADMINISTRATIVE SERVICE CORP
Entity Type:Organization
Organization Name:MEDICAL PHARMACY & LABORATORY ADMINISTRATIVE SERVICE CORP
Other - Org Name:MPL ADMINISTRATIVE SERVICE CORP
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:ROBLEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-707-1943
Mailing Address - Street 1:PO BOX 51991
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950-1991
Mailing Address - Country:US
Mailing Address - Phone:787-707-1943
Mailing Address - Fax:787-706-8823
Practice Address - Street 1:CALLE BARBOSA
Practice Address - Street 2:ESQ SICILIA 404
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-707-1943
Practice Address - Fax:787-706-8823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherPATRONAL