Healthcare Provider Details

I. General information

NPI: 1861929515
Provider Name (Legal Business Name): DEMSLEC MAINTENANCE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2017
Last Update Date: 05/12/2017
Certification Date: DEMSLEC MAINTENANCE SERVICES 2176 L SINGALONG STREET MALATE MANILA SCRANTON PA 18515 2176 L SINGALONG STREET MALATE METRO MANILA MANILA PHILIPPINES 1004
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2176 L SINGALONG STREET MALATE METRO MANILA
MANILA PHILIPPINES
1004
PH

IV. Provider business mailing address

2176 L SINGALONG STREET MALATE MANILA MANILA PHILIPPINES 1004
SCRANTON PA
18515
US

V. Phone/Fax

Practice location:
  • Phone: 632-512-4812
  • Fax:
Mailing address:
  • Phone: 632-512-4812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment
License Number896992
License Number StatePA

VIII. Authorized Official

Name: MS. LAUREANA ESPIA ESTOQUE CORTEZ
Title or Position: ADMIN
Credential:
Phone: 632-512-4812