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General NPI Number Information
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NPI Number | 1619508769
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Entity Type | Organization
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Legal Business Name | SMART BUSINESS GROUP
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Dates
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Enumeration Date | 01/28/2020
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Last Update Date | 01/28/2020
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Provider Practice Location Address
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Address Line | PR-3 KM 152.1 BDA. LOPEZ PARCEL 10
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City | SALINAS
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State | PR
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Zip | 00751
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Country | US
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Telephone | 787-929-6779
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2427
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City | GUAYAMA
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State | PR
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Zip | 00785-2427
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Country | US
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Telephone | 787-929-6779
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. EMMANUEL MEDINA
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Credential | PARAMEDIC
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Telephone | 787-929-6779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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