PREMIUM COMMUNITY CLINIC LLC (NPI# 1811337876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811337876 |
| Entity Type | Organization |
| Organization Name | PREMIUM COMMUNITY CLINIC LLC |
| Practice Address |
4x2 Ave Nogal Lomas Verdes Bayamon PR 00956-2967 |
| Mailing Address |
Po Box 51881 Toa Baja PR 00950-1881 |
| Practice Telephone | 7874444211 |
| Practice Fax Number | 7877916273 |
| Mailing Telephone | 7874444211 |
| Mailing Fax Number | 7877916273 |
| Enumeration Date | 2013-07-04 |
| Last Update Date | 2013-07-04 |
| Authorized Official Name | MISS JENNY YVETTE MARRERO MELENDEZ (PRESIDENT) |
| Authorized Official Telephone | 7874444211 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
PR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PR | DRIVER LICENSE | 4021902 | 01 |
| Street Address |
4X2 AVE NOGAL LOMAS VERDES |
| City | BAYAMON |
| State | PR |
| Zip Code | 00956-2967 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205437514 | Julio Alberto Cedeno Alicea | Pharmacist | Carr. 174 Km. 10.2, Sec. La Morenita Bo. Guaraguao, Bayamon, PR 00956 | 2020-11-03 |
| 1851992275 | Patricia Santurio | Pharmacist | Farmacia Magda C 30, Santa Juanita, Bayamon, PR 00956 | 2020-11-03 |
| 1336754423 | Gustavo Jose Morey Cruz | Physical Therapist | Urb Santa Juanita Calle 30 Uu #43, Bayamon, PR 00956 | 2020-09-15 |
| 1609480961 | Great Vision, LLC | Optometrist | Avenida Laurel Gh1 Ofic #3, Santa Juanita, Bayamon, PR 00956 | 2020-09-03 |
| 1861004285 | Glorilis Zambrana Sr. | Social Worker | Carr. 174 Km 15.3 Barrio Guaraguao Arriba, Sector Chorrera, Bayamon, PR 00956 | 2020-08-18 |
| 1568073484 | Luz Myriam Bracero | Counselor | Carr 174 Km 8.3, Bo Guaraguao Abajo, Bayamon, PR 00956 | 2020-08-13 |
| 1316565641 | Aa Home Rental Inc | Clinical Medical Laboratory | Carr 829 Km,6.2, Bayamon, PR 00956 | 2020-07-13 |
| 1750909495 | Agustin Vazquez | Physician Assistant | Carr 167 Km 10.9, Bayamon, PR 00956 | 2020-07-09 |
| 1710509211 | Carmen Luz Rosa Santiago | Registered Nurse | Carr 829 Km 5.2, Bo. Santa Olaya, Bayamon, PR 00956 | 2020-05-07 |
| 1649891193 | Omar Pantaleon | Student in an Organized Health Care Education/Training Program | Avenida Laurel, Santa Juanita, Bayamon, PR 00956 | 2020-05-06 |
| Find all providers in zip 00956 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689290793 | Metro Pavia Healthcare Centers | Clinic/Center | Carr 167 Urb Bella Vista Marginal Ad-10, Bayamon, PR 00959 | 2020-06-24 |
| 1881016020 | Community Health Foundation of Puerto Rico Inc. | Clinic/Center | Marginal Santa Cruz C-17, Urb. Santa Cruz, Bayamon, PR 00961 | 2014-01-07 |
| 1992092555 | Iniciativa Comunitaria De Investigacion | Clinic/Center | 100 Ave Laurel, Hospital Ramon Ruiz Arnau, Bayamon, PR 00956-4816 | 2011-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707546 | Morovis Community Health Center Inc | Clinic/Center | Bo. Espinosa, Carr 2 Km 30.2, Vega Alta, PR 00692 | 2020-07-20 |
| 1235756339 | Integrate Community Health System | Clinic/Center | Carr # 3, Km 43.8, Bo. Quebrada Fajardo, Fajardo, PR 00738 | 2020-07-06 |
| 1699314500 | Bienestar Health Group | Clinic/Center | Calle Baldorioty 165 Norte, Buzon #2, Barrio Llanos, Aibonito, PR 00705 | 2019-12-26 |
| 1548807951 | Costa Salud Community Health Centers, Inc | Clinic/Center | 124 Calazan Lasalle, Moca, PR 00676 | 2019-12-04 |
| 1811541360 | Macro Health Care, Inc | Clinic/Center | Calle Esteban Quintana Carr 2, Guaynabo, PR 00966-0096 | 2019-08-01 |
| 1245747344 | Jorge E Perez-renta | Clinic/Center | 8169 Calle Concordia Edif San Vicente, Suite 412, Ponce, PR 00717 | 2018-01-10 |
| 1285156885 | Hpm Foundation Inc | Clinic/Center | 65 Infanteria 171, Vieques, PR 00765 | 2017-07-14 |
| 1457892044 | Morovis Community Health Center, Inc. | Clinic/Center | Pr-863 Km 1.0 Sector Pajaros, Bo Candelaria, Toa Baja, PR 00949 | 2017-03-15 |
| 1932557055 | Integrate Community Health System | Clinic/Center | Carr Pr 107 Km 6 Barrio Camaceye, Esq Ave Jardines De Aguadilla, Aguadilla, PR 00603 | 2016-05-31 |
| 1699135228 | A&p Medical Group | Clinic/Center | 23 Calle Amatista Villa Blanca, Caguas, PR 00725 | 2016-02-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.