Provider Demographics
NPI:1992776587
Name:RG ENTERPRISES INC
Entity type:Organization
Organization Name:RG ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:E
Authorized Official - Last Name:GRAJALES
Authorized Official - Suffix:
Authorized Official - Credentials:BS-MT-ASCP
Authorized Official - Phone:787-667-1902
Mailing Address - Street 1:PO BOX 3386
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-3386
Mailing Address - Country:US
Mailing Address - Phone:787-785-3850
Mailing Address - Fax:787-785-3850
Practice Address - Street 1:CALLE ISABEL II, PRIMER NIVEL
Practice Address - Street 2:EDIF. JOAQUIN MONTASINOS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-785-3850
Practice Address - Fax:787-785-3850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR203291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR400137OtherUTI
PR800009OtherMEDICARE Y MUCHO MAS-MMM
PRITINOtherCOSVI
PRITINOtherFIRST PLUS MEDICARE ADVAN
PR20409OtherPREFFERED MEDICARE CHOICE
PRITINOtherMCS & MCS CLASSICARE
PR011203LIOtherGLOBAL HEALTH
PR31438OtherSSS OPTIMO & SSS REFORMA
PRITINOtherCIGNA & CIGNA EXCLUSIVE
PR100620OtherCRUZ AZUL
PRITINOtherMAPFRE & MAPFRE MEDICARE
PR31438ASOtherSSS
PR8753OtherAMERICAN HEALTH
PRITINOtherOPTION HEALTHCARE
PR9840027OtherHUMANA & HUMANA REFORMA
PRLA0620OtherPALIC- PANAMERICAN LIFE
PRA165OtherFIRST MEDICAL- I.M.C.
PRITINOtherMEDPLUS
PR0031438Medicare ID - Type Unspecified