Provider Demographics
NPI:1447609557
Name:BLUE NET HOSPITAL OF MEXICO LLC
Entity Type:Organization
Organization Name:BLUE NET HOSPITAL OF MEXICO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:AUGUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-536-0515
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-0220
Mailing Address - Country:US
Mailing Address - Phone:732-536-0515
Mailing Address - Fax:888-777-4799
Practice Address - Street 1:50B US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1526
Practice Address - Country:US
Practice Address - Phone:732-536-0515
Practice Address - Fax:888-777-4799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital