Provider Demographics
NPI:1396985933
Name:LABORATORIO CLINICO SAHIMAR, INC
Entity type:Organization
Organization Name:LABORATORIO CLINICO SAHIMAR, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPARRO
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-826-4490
Mailing Address - Street 1:PO BOX 1789
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-1789
Mailing Address - Country:US
Mailing Address - Phone:787-891-0303
Mailing Address - Fax:787-891-0303
Practice Address - Street 1:CALLE PROGRESO
Practice Address - Street 2:ESQUINA CORCHADO
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00605
Practice Address - Country:US
Practice Address - Phone:787-891-0303
Practice Address - Fax:787-891-0303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR466291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR466OtherSTATE LICENSE NUMBER
PR31463OtherMEDICARE ID NUMBER