Provider Demographics
NPI:1578309829
Name:CPM NEPHROLOGY LLC
Entity type:Organization
Organization Name:CPM NEPHROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:S
Authorized Official - Last Name:PACHECO MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-242-9540
Mailing Address - Street 1:HOSPITAL BUEN SAMARITANO
Mailing Address - Street 2:18 AVE SEVERIANO CUEVAS, GROUND FLOOR
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603
Mailing Address - Country:US
Mailing Address - Phone:787-997-0101
Mailing Address - Fax:
Practice Address - Street 1:18 AVE SEVERIANO CUEVAS
Practice Address - Street 2:HOSPITAL BUEN SAMARITANO LOBBY
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-242-9540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-06
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty