1447491220 NPI number — HOSPITAL GENERAL DE CASTANER INC

Table of content: JENNIFER CHRISTA MARTZ M.S., BCBA (NPI 1720328669)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447491220 NPI number — HOSPITAL GENERAL DE CASTANER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOSPITAL GENERAL DE CASTANER 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:
FARMACIA POLICLINICA CASTANER
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:
1447491220
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/12/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
44 CALLE GARZAS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ADJUNTAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00601-2108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-829-5656
Provider Business Mailing Address Fax Number:
787-829-5757

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 123 KM 35.7
Provider Second Line Business Practice Location Address:
BO GARZAS
Provider Business Practice Location Address City Name:
ADJUNTAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-829-5656
Provider Business Practice Location Address Fax Number:
787-829-5757
Provider Enumeration Date:
03/09/2009

Additional Information

Authorized Official

Authorized Official Last Name:
JIMENEZ
Authorized Official First Name:
GUILLERMO
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
737-829-5010

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  17-F-2977 , 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: 2119440 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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