Organization
PRYMED MEDICAL CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLADYS RIVERA (EXECUTIVE DIRECTOR)
(787) 871-0601
Entity
Organization
Contact information
Practice address
CALLE 149 KM 13, CIALES, PR 00638
(787) 871-0601
(787) 871-3960
Mailing address
PO BOX 1427, CIALES, PR 00638-1427
(787) 871-0601
(787) 871-3960
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
36
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
401818
MEDICARE PART A
PR
01
—
HQ647A
MEDICARE PART A LAB
PR
Enumeration date
03/08/2006
Last updated
01/27/2016
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