Provider Demographics
NPI:1700917374
Name:BORINQUEN HEALTH CARE, INC.
Entity type:Organization
Organization Name:BORINQUEN HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1787-899-4747
Mailing Address - Street 1:PO BOX 610
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-0610
Mailing Address - Country:US
Mailing Address - Phone:178-789-9474
Mailing Address - Fax:787-899-1611
Practice Address - Street 1:42 CALLE AMISTAD
Practice Address - Street 2:
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667-2058
Practice Address - Country:US
Practice Address - Phone:787-899-4747
Practice Address - Fax:787-899-1611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4444070001Medicare NSC