Provider Demographics
NPI:1730365032
Name:B.M.LABORATORY,INC.
Entity type:Organization
Organization Name:B.M.LABORATORY,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:IDALIZ
Authorized Official - Middle Name:T
Authorized Official - Last Name:MERCADO MORELL
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-872-8888
Mailing Address - Street 1:PO BOX 626
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-0626
Mailing Address - Country:US
Mailing Address - Phone:787-872-8888
Mailing Address - Fax:787-872-8888
Practice Address - Street 1:CARR. 4477 K.M 1.1
Practice Address - Street 2:ARENALES BAJOS
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-872-8888
Practice Address - Fax:787-872-8888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1139291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory