Provider Demographics
NPI:1235217852
Name:PROGRAMA DE SERVICIOS DE SALUD EN EL HOGAR GEMINIS INC
Entity Type:Organization
Organization Name:PROGRAMA DE SERVICIOS DE SALUD EN EL HOGAR GEMINIS INC
Other - Org Name:SERVICIOS DE SALUD EN EL HOGAR GEMINIS Y HOSPICIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENTA
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMERITA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAZQUEZ LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:787-859-5755
Mailing Address - Street 1:PO BOX 1144
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-1144
Mailing Address - Country:US
Mailing Address - Phone:787-859-5755
Mailing Address - Fax:787-859-4307
Practice Address - Street 1:CARR.159 KM 13.4 (BO PUEBLO)
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-1144
Practice Address - Country:US
Practice Address - Phone:787-859-5755
Practice Address - Fax:787-859-4307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR35251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR401563Medicare Oscar/Certification