=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568714806
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEDRITE TECHNOLOGIES INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2012
-----------------------------------------------------
Last Update Date | 10/10/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5340 EL PASO DR SUITE C
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79905-2837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-313-1453
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5340 EL PASO DR SUITE C
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79905-2837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-313-1453
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/MANAGER
-----------------------------------------------------
Name | MR. JOHN ARROYOS I
-----------------------------------------------------
Credential | OWNER
-----------------------------------------------------
Telephone | 915-313-1453
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------