1912992553 NPI number — DOCTORS CENTER HOSPITAL BAYAMON INC

Table of content: (NPI 1912992553)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912992553 NPI number — DOCTORS CENTER HOSPITAL BAYAMON INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DOCTORS CENTER HOSPITAL BAYAMON 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:
1912992553
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2957
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00960-6057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-622-5421
Provider Business Mailing Address Fax Number:
787-622-5432

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 J ST
Provider Second Line Business Practice Location Address:
URB EXTENSION HERMANAS DAVILA
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-622-5421
Provider Business Practice Location Address Fax Number:
787-622-5432
Provider Enumeration Date:
09/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SANTIAGO
Authorized Official First Name:
ALEJANDRO
Authorized Official Middle Name:
Authorized Official Title or Position:
FINANCE DIRECTOR
Authorized Official Telephone Number:
787-854-3322

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  66 , 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: 300011 . This is a "PREFERRED HEALTH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6190041 . This is a "HUMANA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 700012 . This is a "MEDICARE Y MUCHO MAS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 030334 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 10138 . This is a "TRIPLE-S" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 000019 . This is a "UNION INDEPENDIENTE AUTEN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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