Provider Demographics
NPI:1225587207
Name:GRUPO MEDICO HOSPITAL DAMAS, INC.
Entity Type:Organization
Organization Name:GRUPO MEDICO HOSPITAL DAMAS, INC.
Other - Org Name:HOSPITAL DAMAS, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:GERENTE DE CONTRATACIONES Y COBROS
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BONILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-840-8686
Mailing Address - Street 1:2213 BY PASS
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1318
Mailing Address - Country:US
Mailing Address - Phone:787-840-8686
Mailing Address - Fax:787-840-8625
Practice Address - Street 1:2213 BY PASS
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1318
Practice Address - Country:US
Practice Address - Phone:787-840-8686
Practice Address - Fax:787-840-8625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-01
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR53174400000X
261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRHW543AMedicare PIN