Provider Demographics
NPI:1295860633
Name:SOUTHWEST HEALTH CORPORATION
Entity Type:Organization
Organization Name:SOUTHWEST HEALTH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBAHCM
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-851-2025
Mailing Address - Street 1:MUNOZ RIVERA STREET NUM. 108
Mailing Address - Street 2:P.O. BOX 910
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-0910
Mailing Address - Country:US
Mailing Address - Phone:787-851-2025
Mailing Address - Fax:787-254-0235
Practice Address - Street 1:108 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-4060
Practice Address - Country:US
Practice Address - Phone:787-851-2025
Practice Address - Fax:787-254-0235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09F17603336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4023292OtherNCPDP