1285865683 NPI number — SAINT JOSEPH MEDICAL CENTER, S.A. DE C.V.

Table of content: MR. MEDFORD LAMAR HASKEW R.PH. (NPI 1942585187)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285865683 NPI number — SAINT JOSEPH MEDICAL CENTER, S.A. DE C.V.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAINT JOSEPH MEDICAL CENTER, S.A. DE C.V.
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:
1285865683
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
807 VETERANS BLVD APT B
Provider Second Line Business Mailing Address:
#181
Provider Business Mailing Address City Name:
DEL RIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78840-4041
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
830-734-7034
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
775 MADERO ZONA CENTRO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ACUNA
Provider Business Practice Location Address State Name:
COAUHILA
Provider Business Practice Location Address Postal Code:
26200
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
877-943-4673
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/03/2009

Additional Information

Authorized Official

Authorized Official Last Name:
REYES
Authorized Official First Name:
XOCHITL
Authorized Official Middle Name:
P
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
877-943-4673

Provider Taxonomy Codes

  • Taxonomy code: 207RX0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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