Provider Demographics
NPI:1225797160
Name:CORPORACION SERVICIOS MEDICOS PRIMARIOS Y PREVENCION DE HATILLO
Entity Type:Organization
Organization Name:CORPORACION SERVICIOS MEDICOS PRIMARIOS Y PREVENCION DE HATILLO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:YAZMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-898-4190
Mailing Address - Street 1:PO BOX 907
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-0907
Mailing Address - Country:US
Mailing Address - Phone:787-898-4190
Mailing Address - Fax:
Practice Address - Street 1:PR 2 KM 86.6 INTERIOR
Practice Address - Street 2:MARGINAL NORTE BO. PUEBLO
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-898-4190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-08
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center