1336248947 NPI number — HOSPITAL SANTA ROSA 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 1336248947 NPI number — HOSPITAL SANTA ROSA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOSPITAL SANTA ROSA 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:
1336248947
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10008
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GUAYAMA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00785
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-864-0101
Provider Business Mailing Address Fax Number:
787-866-0489

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AVE LOS VETERANOS CARR 3 SALIDA HACIA ARROYO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GUAYAMA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00784
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-864-0101
Provider Business Practice Location Address Fax Number:
787-866-0489
Provider Enumeration Date:
09/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DIAZ VILA
Authorized Official First Name:
GLORIA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
787-864-0810

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  LICENSE39 , 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: 17034SA . This is a "SSS DED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10034SA . This is a "SSS HOSP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 18034SA . This is a "SSS CIR AMB" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1169 . This is a "IMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30083SA . This is a "SSS OPD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 030131 . This is a "LA CRUZ AZUL DE PR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5000181 . This is a "ACAA EMER Y ANCILARES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 73501 . This is a "FSE" identifier . This identifiers is of the category "OTHER".
  • Identifier: FH0604 . This is a "UIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: H301 . This is a "PLAN DE SALUD MENONITA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 19034SA . This is a "SSS EMERG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0120596 . This is a "ACAA COMP MEDICO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 300041 . This is a "PREFERRED HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5000181 . This is a "ACAA HOSP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6540001 . This is a "HUMANA HEALTH INS" identifier . This identifiers is of the category "OTHER".




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