Golden Age Garden Nursing Home

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

31904 Issued in PR

Legal business name

GOLDEN AGE GARDEN NURSING HOME

Practice address

HC 67 Box 15513
Fajardo, PR 00738-9705

Phone

(787) 613-9827

NPI assigned

Jun 4, 2008

Last updated

Jun 4, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Omar Rosa Lopez, RN BSN 31904

Title

Supervisor

Phone

(787) 860-6835

Specialties & licenses 1

Addresses

Other names 1

• NOVA INFUSION Other name

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212537600000",
    "number": "1740449834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 67 BOX 15513",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007389705",
            "telephone_number": "787-613-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 67 BOX 15513",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007389705",
            "telephone_number": "787-613-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN AGE GARDEN NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-04",
        "last_updated": "2008-06-04",
        "status": "A",
        "authorized_official_last_name": "ROSA LOPEZ",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "787-860-6835",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN BSN 31904"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "PR",
            "license": "31904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NOVA INFUSION",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Genesis Medical Equipment and Pharmacy
• Genesis Medical Equipment and Pharmacy Inc
• Genesis Medical Supply and Medical Equipment
• Gobierno Municipal de Fajardo
• Gobierno Municipal de Fajardo
• Eugenio Gomez Garcia
• Gonzalez Negrin Corp (Farmacia Santa Isidra)
• Carlos Manuel Gonzalez Pagan, M.D.
• Nancy Gonzalez
• Good Vision

• Nursing Facility/Intermediate Care Facility in Fajardo, PR
• Providers in Fajardo, PR by specialty
• Nursing Facility/Intermediate Care Facility in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.