Northwestern Medical Lab Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

309 Issued in PR

Legal business name

NORTHWESTERN MEDICAL LAB INC

Practice address

24 Ave Severiano Cuevas Ste 101
Aguadilla Medical Plaza
Aguadilla, PR 00603-5762

Phone

(787) 891-1481

Fax

(787) 891-1481

NPI assigned

May 15, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Marisol Mendez, M.T.NPI 1205967437

Title

President

Phone

(787) 891-1481

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marisol Mendez, M.T.

  • Clinical Medical Laboratory
  • Aguadilla, PR
  • NPI 1205967437
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508803200000",
    "number": "1124234422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250451",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006040451",
            "telephone_number": "787-891-1481",
            "fax_number": "787-891-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 AVE SEVERIANO CUEVAS STE 101",
            "address_2": "AGUADILLA MEDICAL PLAZA",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006035762",
            "telephone_number": "787-891-1481",
            "fax_number": "787-891-1481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN MEDICAL LAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2017-10-24",
        "status": "A",
        "authorized_official_last_name": "MENDEZ",
        "authorized_official_first_name": "MARISOL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-891-1481",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.T."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Northwest Primary Healthcare Center, PSC
• Northwestern Renal Care PSC
• Marcelo Oben Martinez, MD
• Odemaris Laboratory Inc
• Ohi of Puerto Rico, LLC
• Omar Soto Barreto

• Clinical Medical Laboratory in Aguadilla, PR
• Providers in Aguadilla, PR by specialty
• Clinical Medical Laboratory in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.