1417969411 NPI number — MOROVIS COMMUNITY HEALTH CENTER, INC.

Table of content: (NPI 1417969411)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417969411 NPI number — MOROVIS COMMUNITY HEALTH CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOROVIS COMMUNITY HEALTH CENTER, 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:
1417969411
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 518
Provider Second Line Business Mailing Address:
2 PATRON STREET
Provider Business Mailing Address City Name:
MOROVIS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00687-0518
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-862-3000
Provider Business Mailing Address Fax Number:
787-862-2731

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 PATRON STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOROVIS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00687-0518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-862-3000
Provider Business Practice Location Address Fax Number:
787-862-2731
Provider Enumeration Date:
08/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RODRIGUEZ-CASTRO
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
787-862-3000

Provider Taxonomy Codes

  • Taxonomy code: 261QC1500X , with the licence number:  20 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 30753 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 0119792 . This is a "ACAA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 200247 . This is a "PREFERRED HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6870002 . This is a "HUMANA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 40006 . This is a "PMC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 40006-B . This is a "PMC DR. SANCHEZ" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 40006-C . This is a "PMC DRA. GONZALEZ" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 40006-D . This is a "PMC DR. CASIANO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 40006-F . This is a "PMC DRA. RIVERA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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