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General NPI Number Information
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NPI Number | 1407823800
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Entity Type | Organization
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Legal Business Name | GIACRIMAR CORP
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Dates
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Enumeration Date | 03/03/2006
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 208 AVE JOSE DE DIEGO
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City | ARECIBO
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State | PR
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Zip | 00612-4585
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Country | US
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Telephone | 787-878-4670
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Fax | 787-816-6948
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Provider Business Mailing Address
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Address Line | PO BOX 1554
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City | ARECIBO
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State | PR
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Zip | 00613-1554
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Country | US
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Telephone | 787-878-4670
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Fax | 787-816-6948
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JUAN CARLOS GONZALEZ
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Credential |
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Telephone | 787-878-4670
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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 | 443
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License Number State | PR
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