1487246807 NPI number — HOSPITAL MENONITA GUAYAMA INC

Table of content: (NPI 1487246807)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487246807 NPI number — HOSPITAL MENONITA GUAYAMA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOSPITAL MENONITA GUAYAMA 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:
1487246807
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1650
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CIDRA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00739-1650
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-434-1700
Provider Business Mailing Address Fax Number:
787-434-1715

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HOSPITAL MENONIYA DE GUAYAMA
Provider Second Line Business Practice Location Address:
AVE. PEDRO ALBIZU CAMPOS URB LA HACIENDA
Provider Business Practice Location Address City Name:
GUAYAMA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00785-0011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-434-1700
Provider Business Practice Location Address Fax Number:
787-434-1715
Provider Enumeration Date:
02/08/2021

Additional Information

Authorized Official

Authorized Official Last Name:
VAZQUEZ RIVERA
Authorized Official First Name:
LISSETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING AND COLLECTOR DIRECTOR
Authorized Official Telephone Number:
787-434-1700

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 17-086 . This is a "CNC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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