Basic Information
Provider Information
NPI: 1306126461
EntityType: 2
ReplacementNPI:  
OrganizationName: PRESBYTERIAN COMMUNITY HOSPITAL INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1451 ASHFORD
Address2:  
City: SAN JUAN
State: PR
PostalCode: 009071511
CountryCode: US
TelephoneNumber: 7877212160
FaxNumber: 7877233797
Practice Location
Address1: 1451 AVE ASHFORD
Address2:  
City: SAN JUAN
State: PR
PostalCode: 009071511
CountryCode: US
TelephoneNumber: 7877212160
FaxNumber: 7877233797
Other Information
ProviderEnumerationDate: 08/22/2011
LastUpdateDate: 08/22/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ORITZ
AuthorizedOfficialFirstName: MILAGROS
AuthorizedOfficialMiddleName: A
AuthorizedOfficialTitleorPosition: CHIF FINANCIAL NUMBER
AuthorizedOfficialTelephone: 7877212160
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: CPA
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X  Y HospitalsGeneral Acute Care Hospital 

No ID Information.


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