Provider Demographics
NPI:1962888925
Name:PRIMARY & OCCUPATIONAL MEDICAL OFFICE INC
Entity type:Organization
Organization Name:PRIMARY & OCCUPATIONAL MEDICAL OFFICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-615-4079
Mailing Address - Street 1:PO BOX 1605
Mailing Address - Street 2:
Mailing Address - City:BOQUERON
Mailing Address - State:PR
Mailing Address - Zip Code:00622-1605
Mailing Address - Country:US
Mailing Address - Phone:787-615-4079
Mailing Address - Fax:787-255-2929
Practice Address - Street 1:CARR #2 KM 129.3
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-9998
Practice Address - Country:US
Practice Address - Phone:787-615-4079
Practice Address - Fax:787-851-8998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR015496OtherGENERAL PRACTICE