Provider Demographics
NPI:1154326882
Name:HOSPITAL EPISCOPAL SAN LUCAS GUAYAMA INC.
Entity Type:Organization
Organization Name:HOSPITAL EPISCOPAL SAN LUCAS GUAYAMA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DEL ROSARIO
Authorized Official - Last Name:TORRES RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-864-4300
Mailing Address - Street 1:PO BOX 10011
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-0011
Mailing Address - Country:US
Mailing Address - Phone:787-864-4300
Mailing Address - Fax:787-864-4466
Practice Address - Street 1:AVENIDA PEDRO ALBIZU CAMPOS ESQUINA URB LA HACIENDA
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00785
Practice Address - Country:US
Practice Address - Phone:787-864-4300
Practice Address - Fax:787-864-4466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR54282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR70007OtherMMM
PR2613OtherIMC
PR7850009OtherHUMANA
PR19982Other19982
PR030311OtherCRUZ AZUL
PR3019OtherPROSSAM
PR300097OtherUTI
PR70007OtherMMM
PR=========OtherMENONITA