Healthcare Provider Details

I. General information

NPI: 1174914154
Provider Name (Legal Business Name): PRYMED MEDICAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2015
Last Update Date: 02/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROAD #2 KM 39.8 BO. ALGARROBO
VEGA BAJA PR
00693-0000
US

IV. Provider business mailing address

PO BOX 1427
CIALES PR
00638-1427
US

V. Phone/Fax

Practice location:
  • Phone: 787-871-0601
  • Fax: 787-871-3960
Mailing address:
  • Phone: 787-871-0601
  • Fax: 978-787-1396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number1322
License Number StatePR

VIII. Authorized Official

Name: MRS. MARISOL VEGA
Title or Position: FINANCE DIRECTOR
Credential: BA
Phone: 787-871-0601