Provider Demographics
NPI:1306922737
Name:FREMANOR, INC.
Entity type:Organization
Organization Name:FREMANOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/M.T.
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:H
Authorized Official - Last Name:COLLAZO
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-270-1717
Mailing Address - Street 1:PO BOX 3031
Mailing Address - Street 2:
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-3031
Mailing Address - Country:US
Mailing Address - Phone:787-270-1717
Mailing Address - Fax:787-270-1717
Practice Address - Street 1:CENTRO GRAN CARIBE MALL
Practice Address - Street 2:SECOND LEVEL OFFICE 205
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-270-1717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1038291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory