Provider Demographics
NPI:1962825893
Name:PRIMA IMAGING, PSC
Entity Type:Organization
Organization Name:PRIMA IMAGING, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTACT PERSON
Authorized Official - Prefix:MRS
Authorized Official - First Name:NILSA
Authorized Official - Middle Name:C
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-787-7411
Mailing Address - Street 1:PO BOX 3161
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-3161
Mailing Address - Country:US
Mailing Address - Phone:787-787-7411
Mailing Address - Fax:787-286-7572
Practice Address - Street 1:Z40 AVE LAUREL LOMAS VERDES
Practice Address - Street 2:URB LOMAS VERDES
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-0000
Practice Address - Country:US
Practice Address - Phone:787-785-1011
Practice Address - Fax:787-286-7572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRIC073AMedicare UPIN