Provider Demographics
NPI:1013135375
Name:MIR AMERICA CO.
Entity Type:Organization
Organization Name:MIR AMERICA CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MIGOYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-657-4806
Mailing Address - Street 1:300 7TH ST
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07029-2006
Mailing Address - Country:US
Mailing Address - Phone:201-657-4806
Mailing Address - Fax:
Practice Address - Street 1:300 7TH ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NJ
Practice Address - Zip Code:07029-2006
Practice Address - Country:US
Practice Address - Phone:201-657-4806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA021722Medicare ID - Type Unspecified