Provider Demographics
NPI:1366484594
Name:HOSPITAL DE LA CONCEPCION INC
Entity Type:Organization
Organization Name:HOSPITAL DE LA CONCEPCION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CRESPO
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-892-1860
Mailing Address - Street 1:PO BOX 285
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-0285
Mailing Address - Country:US
Mailing Address - Phone:787-892-1860
Mailing Address - Fax:787-264-7908
Practice Address - Street 1:ROUTE #2 KM 173.4
Practice Address - Street 2:BO. CAIN ALTO
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4266
Practice Address - Country:US
Practice Address - Phone:787-892-1860
Practice Address - Fax:787-264-7908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR57282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR10018OtherSSS PROVIDER ID
PR10018OtherSSS PROVIDER ID
PR400021Medicare ID - Type Unspecified