| Premium Community Clinic Llc | |
|
4x2 Ave Nogal Lomas Verdes Bayamon PR 00956-2967 | |
| (787) 444-4211 | |
| (787) 791-6273 |
| Full Name | Premium Community Clinic Llc |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 4x2 Ave Nogal, Bayamon, Puerto Rico |
| Authorized Official Name and Position | Jenny Yvette Marrero Melendez (PRESIDENT) |
| Authorized Official Contact | 7874444211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premium Community Clinic Llc Po Box 51881 Toa Baja PR 00950-1881 Ph: (787) 444-4211 | Premium Community Clinic Llc 4x2 Ave Nogal Lomas Verdes Bayamon PR 00956-2967 Ph: (787) 444-4211 |
| NPI Number | 1811337876 |
|---|---|
| Provider Enumeration Date | 07/04/2013 |
| Last Update Date | 07/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811337876 | NPI | - | NPPES |
| 4021902 | Other | PR | DRIVER LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (Puerto Rico) | Primary |
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