Provider Demographics
NPI:1881938652
Name:LANTHEUS MI RADIOPHARMACEUTICALS, INC.
Entity type:Organization
Organization Name:LANTHEUS MI RADIOPHARMACEUTICALS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:CORDERO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, BCNP
Authorized Official - Phone:787-765-5598
Mailing Address - Street 1:150 CALLE FEDERICO COSTA STE 1
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-1339
Mailing Address - Country:US
Mailing Address - Phone:787-765-5598
Mailing Address - Fax:787-763-4042
Practice Address - Street 1:150 CALLE FEDERICO COSTA STE 1
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1339
Practice Address - Country:US
Practice Address - Phone:787-765-5598
Practice Address - Fax:787-763-4042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13-F-27193336N0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336N0007XSuppliersPharmacyNuclear Pharmacy