Basic Information
| Provider Information | |||||||||
| NPI: | 1215179437 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GAMSHAR IMAGES SERVICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7346 | ||||||||
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| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007327346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878431625 | ||||||||
| FaxNumber: | 7878120565 | ||||||||
| Practice Location | |||||||||
| Address1: | 9176 CALLE MARINA | ||||||||
| Address2: | |||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007311582 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878431625 | ||||||||
| FaxNumber: | 7878120565 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2009 | ||||||||
| LastUpdateDate: | 04/02/2009 | ||||||||
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| AuthorizedOfficialLastName: | LOPEZ | ||||||||
| AuthorizedOfficialFirstName: | SHARON | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | VP/ SECRETARY | ||||||||
| AuthorizedOfficialTelephone: | 7878431625 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085B0100X | 08042 | PR | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Body Imaging |
No ID Information.