Provider Demographics
NPI:1114367448
Name:MATERCARE LLC
Entity type:Organization
Organization Name:MATERCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF TECHNOLOGY OFFICER & DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:XAVIER
Authorized Official - Middle Name:ALEXIS
Authorized Official - Last Name:TRAVERSO
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:787-236-6767
Mailing Address - Street 1:PO BOX 364087
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4087
Mailing Address - Country:US
Mailing Address - Phone:787-753-7800
Mailing Address - Fax:787-753-4882
Practice Address - Street 1:520 CALLE JOSE R ACOSTA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2847
Practice Address - Country:US
Practice Address - Phone:787-753-7800
Practice Address - Fax:787-753-4882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-01
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
No176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty