1164881140 NPI number — SOUTHERN HOSPITAL SERVICES 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 1164881140 NPI number — SOUTHERN HOSPITAL SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHERN HOSPITAL SERVICES 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:
1164881140
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/18/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1441
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JUANA DIAZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00795-1441
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-971-0040
Provider Business Mailing Address Fax Number:
787-260-1441

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 153 ESQ 52
Provider Second Line Business Practice Location Address:
BARRIO FELICIA 2 EDIFICIO PROFESSIONAL
Provider Business Practice Location Address City Name:
SANTA ISABEL
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00757
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-971-0040
Provider Business Practice Location Address Fax Number:
787-260-1441
Provider Enumeration Date:
02/18/2016

Additional Information

Authorized Official

Authorized Official Last Name:
TORRES
Authorized Official First Name:
DIANA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
VICE PRESIDENTA OPERACIONES
Authorized Official Telephone Number:
787-837-2265

Provider Taxonomy Codes

  • Taxonomy code: 261QE0002X , with the licence number:  110 , 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)





Copyright © 2007-2026 www.npivalidator.com