Provider Demographics
NPI:1083093850
Name:HOSPITAL HIMA SAN PABLO CUPEY
Entity Type:Organization
Organization Name:HOSPITAL HIMA SAN PABLO CUPEY
Other - Org Name:HOSPITAL SAN GERARDO CUPEY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN/GENERALIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HEZEKIAH
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:OWOJUYIGBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-610-6632
Mailing Address - Street 1:PMB 250
Mailing Address - Street 2:138 WINSTON CHURCHILL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6013
Mailing Address - Country:US
Mailing Address - Phone:787-305-8383
Mailing Address - Fax:787-961-1919
Practice Address - Street 1:138 AVE WINSTON CHURCHILL
Practice Address - Street 2:PMB 250
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6013
Practice Address - Country:US
Practice Address - Phone:787-305-8383
Practice Address - Fax:787-961-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13606I282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital