Basic Information
| Provider Information | |||||||||
| NPI: | 1356675458 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DEPT OF HEALTH, GOVT OF VI/MORRIS DECASTRO CLINIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1303 HOSPITAL GROUND, STE#10 | ||||||||
| Address2: | |||||||||
| City: | ST. THOMAS | ||||||||
| State: | VI | ||||||||
| PostalCode: | 00802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3407768311 | ||||||||
| FaxNumber: | 3407774001 | ||||||||
| Practice Location | |||||||||
| Address1: | 4D STRAND STREET | ||||||||
| Address2: | |||||||||
| City: | CRUZ BAY, ST JOHN | ||||||||
| State: | VI | ||||||||
| PostalCode: | 00803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3407777477 | ||||||||
| FaxNumber: | 3407774001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2009 | ||||||||
| LastUpdateDate: | 09/23/2009 | ||||||||
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| AuthorizedOfficialLastName: | SHEEN | ||||||||
| AuthorizedOfficialFirstName: | JULIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | COMMISSIONER OF HEALTH | ||||||||
| AuthorizedOfficialTelephone: | 3407731311 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MPH | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251K00000X | Y | Agencies | Public Health or Welfare |
No ID Information.