Provider Demographics
NPI:1477004851
Name:CAMUY HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:CAMUY HEALTH SERVICES, INC
Other - Org Name:VACUNACION CHSI
Other - Org Type:Other Name
Authorized Official - Title/Position:BACK OFFICE OFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:YAZMIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-262-6603
Mailing Address - Street 1:63 MUNOZ RIVERA AVENUE
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627
Mailing Address - Country:US
Mailing Address - Phone:787-262-6603
Mailing Address - Fax:
Practice Address - Street 1:63 MUNOZ RIVERA AVENUE
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-0660
Practice Address - Country:US
Practice Address - Phone:787-262-6603
Practice Address - Fax:787-262-1210
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAMUY HEALTH SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0082062Medicare PIN