1528273992 NPI number — VEGA ALTA HOSPICE CARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528273992 NPI number — VEGA ALTA HOSPICE CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VEGA ALTA HOSPICE CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528273992
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/24/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 459
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VEGA ALTA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00692
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-270-4838
Provider Business Mailing Address Fax Number:
787-270-4972

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE MUNOZ RIVERA #1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VEGA ALTA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00692
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-270-4838
Provider Business Practice Location Address Fax Number:
787-270-4972
Provider Enumeration Date:
05/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TIRADO VALENTIN
Authorized Official First Name:
ITZALIA
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
787-270-4838

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  401565 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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