Provider Demographics
NPI:1841531472
Name:PREMIER ORTHOPEDICS, INC
Entity type:Organization
Organization Name:PREMIER ORTHOPEDICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:REXACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-294-6904
Mailing Address - Street 1:102 FD ROOSEVELT AVE.
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917
Mailing Address - Country:US
Mailing Address - Phone:787-294-6904
Mailing Address - Fax:787-294-6253
Practice Address - Street 1:102 FD ROOSEVELT
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917
Practice Address - Country:US
Practice Address - Phone:787-294-6904
Practice Address - Fax:787-294-6253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies