Provider Demographics
NPI:1366821969
Name:TA COMMUNITY HEALTH, INC
Entity Type:Organization
Organization Name:TA COMMUNITY HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:AWILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUQUE GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-379-9665
Mailing Address - Street 1:PO BOX 1558
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00954-1558
Mailing Address - Country:US
Mailing Address - Phone:787-230-7190
Mailing Address - Fax:787-230-7190
Practice Address - Street 1:816 BARCELO
Practice Address - Street 2:
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953
Practice Address - Country:US
Practice Address - Phone:787-230-7190
Practice Address - Fax:787-230-7190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care