Basic Information
| Provider Information | |||||||||
| NPI: | 1306492616 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAINT LUKES MEMORIAL HOSPITAL INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 336810 | ||||||||
| Address2: | |||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007336810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878442080 | ||||||||
| FaxNumber: | 7878442090 | ||||||||
| Practice Location | |||||||||
| Address1: | 917 AVE TITO CASTRO | ||||||||
| Address2: | |||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007164717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878442080 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2019 | ||||||||
| LastUpdateDate: | 08/13/2019 | ||||||||
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| AuthorizedOfficialLastName: | PONTON CRUZ | ||||||||
| AuthorizedOfficialFirstName: | ELYONEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRICIPAL EJECUTIVO OPERACIONAL | ||||||||
| AuthorizedOfficialTelephone: | 7878442080 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.