Provider Demographics
NPI:1144326398
Name:VACUNACION DEL NORTE, INC.
Entity type:Organization
Organization Name:VACUNACION DEL NORTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTORA EJECUTIVA
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES BERROCAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-344-1328
Mailing Address - Street 1:PO BOX 140187
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-0187
Mailing Address - Country:US
Mailing Address - Phone:787-344-1328
Mailing Address - Fax:787-817-0494
Practice Address - Street 1:CARRETERA 681 KM 4.5 INT
Practice Address - Street 2:BO ISLOTE
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00614
Practice Address - Country:US
Practice Address - Phone:787-344-1328
Practice Address - Fax:787-817-0494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07B3151261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR19221OtherTRIPLE S, INC.