1295732899 NPI number — HOSPITAL EPISCOPAL SAN LUCAS

Table of content: (NPI 1295732899)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295732899 NPI number — HOSPITAL EPISCOPAL SAN LUCAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOSPITAL EPISCOPAL SAN LUCAS
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:
HOSPITAL SAN LUCAS I
Provider Other Organization Name Type Code:
3
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:
1295732899
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 332027
Provider Second Line Business Mailing Address:
CALLE GUADALUPE FINAL #184
Provider Business Mailing Address City Name:
PONCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00733-2027
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-840-4545
Provider Business Mailing Address Fax Number:
787-841-0008

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
184 CALLE GUADALUPE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00730-3561
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-840-4545
Provider Business Practice Location Address Fax Number:
787-841-0008
Provider Enumeration Date:
06/29/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CORA
Authorized Official First Name:
JOSE
Authorized Official Middle Name:
JOAQUIN
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
787-840-4545

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  54 , 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)

  • Identifier: 10020 . This is a "TRIPLE C" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 17020 . This is a "TRIPLE S" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 92399 . This is a "TRIPLE C PATHOLOGY" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 30048 . This is a "UTI" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 2795 . This is a "INTERNATIONAL MEDICAL CAR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 30036 . This is a "TRIPLE C AMBULATORY" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 18020 . This is a "TRIPLE S" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 19020 . This is a "TRIPLE C" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 300077 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 30794 . This is a "TRIPLE C CATH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".