NPIMap

Organization Active NPI

Trixymar Inc

Doing business as Laboratorio Clinico y Bacteriologico Trixymar

  • Clinical Medical Laboratory
  • Maunabo, PR
National Provider Identifier
1437310653
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
1230 Issued in PR
Legal business name
TRIXYMAR INC
Doing business as
Laboratorio Clinico y Bacteriologico Trixymar
Practice address
17 Calle Luis Munoz Rivera
Maunabo, PR 00707-2147
Phone
(787) 861-1111
Fax
(787) 861-4444
NPI assigned
Jun 20, 2008
Last updated
Jun 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Authorized official

Name
Mr. Luis Diaz-Vega Sr.
Title
Administrador
Phone
(787) 861-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 1230 PR Primary

Addresses

Primary practice location

17 Calle Luis Munoz Rivera
Maunabo, PR 00707-2147

Mailing address

PO Box 97
Maunabo, PR 00707-0097
Phone (787) 861-1111

Other names 1

  • Laboratorio Clinico y Bacteriologico Trixymar Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110210000194 PR Part B Supplier - Independent Clinical Laboratory 8527248434 2 other NPIs on this enrollment
Practice locations: Arroyo, PR; Humacao, PR; Maunabo, PR

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Laboratorio Clinico Trixymar Jardines de Arroyo4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

17 Calle Luis Munoz Rivera
Maunabo, PR 00707
Phone (787) 861-1111

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624838400000",
    "number": "1437310653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "MAUNABO",
            "state": "PR",
            "postal_code": "007070097",
            "telephone_number": "787-861-1111",
            "fax_number": "787-861-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 CALLE LUIS MUNOZ RIVERA",
            "city": "MAUNABO",
            "state": "PR",
            "postal_code": "007072147",
            "telephone_number": "787-861-1111",
            "fax_number": "787-861-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIXYMAR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-20",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A",
        "authorized_official_last_name": "DIAZ-VEGA",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "ADMINISTRADOR",
        "authorized_official_telephone_number": "787-861-1111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laboratorio Clinico y Bacteriologico Trixymar",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maunabo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.