Provider Demographics
NPI:1265760706
Name:POLICLINICAS SALUD DEL NORTE
Entity type:Organization
Organization Name:POLICLINICAS SALUD DEL NORTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-855-4011
Mailing Address - Street 1:105 CARR 687
Mailing Address - Street 2:BO ALGARROBO
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-6200
Mailing Address - Country:US
Mailing Address - Phone:787-855-4011
Mailing Address - Fax:787-855-4014
Practice Address - Street 1:105 CARR 687
Practice Address - Street 2:BO ALGARROBO
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-6200
Practice Address - Country:US
Practice Address - Phone:787-855-4011
Practice Address - Fax:787-855-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization