Provider Demographics
NPI:1467692269
Name:DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:DEPARTMENT OF HEALTH
Other - Org Name:RYAN WHITE PART B/ AIDS DRUGS ASSISTANCE PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:ADAP PROGRAM COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOPEZ DE VICTORIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-766-2805
Mailing Address - Street 1:PO BOX 70184
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8184
Mailing Address - Country:US
Mailing Address - Phone:787-766-2805
Mailing Address - Fax:787-766-7015
Practice Address - Street 1:198 CALLE TRINIDAD
Practice Address - Street 2:URB PINEIRO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-2900
Practice Address - Country:US
Practice Address - Phone:787-766-2805
Practice Address - Fax:787-766-7015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management