Provider Demographics
NPI:1346447265
Name:MED HEALTH HOSPICE CORP
Entity Type:Organization
Organization Name:MED HEALTH HOSPICE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MONTALVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-254-4307
Mailing Address - Street 1:154 CARR 102
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-3138
Mailing Address - Country:US
Mailing Address - Phone:787-254-4307
Mailing Address - Fax:787-254-4307
Practice Address - Street 1:BO GUANAJIBO SECTOR PARABUEYON
Practice Address - Street 2:CARR 102 KM 18.6
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623
Practice Address - Country:US
Practice Address - Phone:787-254-4307
Practice Address - Fax:787-254-4307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001367251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR401567OtherMEDICARE HOSPICE PROVIDER NUMBER