Provider Demographics
NPI:1518963446
Name:HOSPITAL LAFAYETTE
Entity Type:Organization
Organization Name:HOSPITAL LAFAYETTE
Other - Org Name:ASOCIACION AZUCARERA COOPERATIVA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRADOR
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:M
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA,RHIA
Authorized Official - Phone:787-839-3232
Mailing Address - Street 1:PO BOX 207
Mailing Address - Street 2:
Mailing Address - City:ARROYO
Mailing Address - State:PR
Mailing Address - Zip Code:00714-0207
Mailing Address - Country:US
Mailing Address - Phone:787-839-3232
Mailing Address - Fax:787-839-2525
Practice Address - Street 1:CARRE #753 KM 0.1
Practice Address - Street 2:
Practice Address - City:ARROYO
Practice Address - State:PR
Practice Address - Zip Code:00714-0207
Practice Address - Country:US
Practice Address - Phone:787-839-3232
Practice Address - Fax:787-839-2525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-24
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR34282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR400026Medicare Oscar/Certification