Provider Demographics
NPI:1144613514
Name:MENNONITE GENERAL HOSPITAL INC.
Entity Type:Organization
Organization Name:MENNONITE GENERAL HOSPITAL INC.
Other - Org Name:SALUD EN EL HOGAR MENONITA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATONG OFFICER (COO)
Authorized Official - Prefix:
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-535-1001
Mailing Address - Street 1:PO BOX 1379
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-1379
Mailing Address - Country:US
Mailing Address - Phone:787-735-1955
Mailing Address - Fax:787-735-1525
Practice Address - Street 1:4 CALLE DR TROYER
Practice Address - Street 2:URB VILLA ROSALES
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-3304
Practice Address - Country:US
Practice Address - Phone:787-735-1955
Practice Address - Fax:787-735-1525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-10
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health