NPIMap

Organization Active NPI

Fernando Hernandez

Doing business as 121 century medical lab

  • Clinical Medical Laboratory
  • Scottsbluff, NE
National Provider Identifier
1902935406
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
FERNANDO HERNANDEZ
Doing business as
121 century medical lab
Practice address
713 W 27TH St
Scottsbluff, NE 69361-4412
Phone
(187) 730-7665
NPI assigned
Mar 2, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Fernando Hernandez
Title
President
Phone
(877) 307-6654

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NE Primary

Addresses

Primary practice location

713 W 27TH St
Scottsbluff, NE 69361-4412

Mailing address

713 W 27TH St
Scottsbluff, NE 69361-4412
Phone (187) 730-7665

Other names 1

  • 121 century medical lab Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902935406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 W 27TH ST",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614412",
            "telephone_number": "187-730-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 W 27TH ST",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614412",
            "telephone_number": "187-730-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERNANDO HERNANDEZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "18773076654"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "121 century medical lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Scottsbluff, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.