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General NPI Number Information
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NPI Number | 1346239654
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Entity Type | Organization
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Legal Business Name | EMPRESAS JERICO INC.
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 07/11/2012
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Provider Practice Location Address
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Address Line | 30 CALLE SALVADOR BRAU
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City | CABO ROJO
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State | PR
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Zip | 00623-3417
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Country | US
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Telephone | 787-851-1007
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Fax | 787-255-2680
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Provider Business Mailing Address
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Address Line | 30 CALLE SALVADOR BRAU
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City | CABO ROJO
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State | PR
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Zip | 00623-3417
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Country | US
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Telephone | 787-851-1007
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Fax | 787-255-2680
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. FRANCIS MERCADO
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Credential |
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Telephone | 787-851-1007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 488
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License Number State | PR
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