NPIMap

Organization Active NPI

Centro de Salud de Lares, Inc.

  • Clinical Medical Laboratory
  • Lares, PR
National Provider Identifier
1750589982
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
741 Issued in PR
Legal business name
CENTRO DE SALUD DE LARES, INC.
Practice address
Road 111, KM. 1.9
Ave. Los Patriotas
Lares, PR 00669-0379
Phone
(787) 897-2727
Fax
(787) 897-2725
NPI assigned
Jul 10, 2007
Last updated
Jul 10, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRO DE SALUD DE LARES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Authorized official

Name
Mr. Rigoberto Hernandez
Title
Executive Director
Phone
(787) 897-2727

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 741 PR Primary

Addresses

Primary practice location

Road 111, KM. 1.9
Ave. Los Patriotas
Lares, PR 00669-0379

Mailing address

PO Box 379
Lares, PR 00669-0379
Phone (787) 897-2727

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080110000143 PR Part B Supplier - Independent Clinical Laboratory 0840272985 Practice locations: Lares, PR

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Lab CDT Quebradillas23 organizations share this tax ID, including this one
Part of
Lab CDT Quebradillas

Other organizations with this tax ID 22

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

View all 22

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Centros Integrados de Servicios de Salud Lares QuebradillasLares, PR, CCN 401824 Federally qualified health center Operational/Managerial Control May 27, 1986
Centros Integrados de Servicios de Salud Lares QuebradillasQuebradillas, PR, CCN 401823 Federally qualified health center Operational/Managerial Control Apr 1, 1995

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1750589982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 379",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006690379",
            "telephone_number": "787-897-2727",
            "fax_number": "787-897-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROAD 111, KM. 1.9",
            "address_2": "AVE. LOS PATRIOTAS",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006690379",
            "telephone_number": "787-897-2727",
            "fax_number": "787-897-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO DE SALUD DE LARES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRO DE SALUD DE LARES, INC.",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "RIGOBERTO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "787-897-2727",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lares, PR

Sources for this page

Verify at the official NPI Registry.