Provider Demographics
NPI:1639321102
Name:OUR LADY OF PURIFICACION DOCTORS HOSPITAL,INC.
Entity Type:Organization
Organization Name:OUR LADY OF PURIFICACION DOCTORS HOSPITAL,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FAITH AMORFINA
Authorized Official - Middle Name:T
Authorized Official - Last Name:SUBIDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:63074-445-7001
Mailing Address - Street 1:SUITE 410, MT. CREST HOTEL LEGARDA ROAD, BAGUIO CITY
Mailing Address - Street 2:
Mailing Address - City:BAGUIO
Mailing Address - State:BENGUET
Mailing Address - Zip Code:26000
Mailing Address - Country:PH
Mailing Address - Phone:63074-445-7001
Mailing Address - Fax:
Practice Address - Street 1:SUITE 410, MT. CREST HOTEL LEGARDA ROAD, BAGUIO CITY
Practice Address - Street 2:
Practice Address - City:BAGUIO
Practice Address - State:BENGUET
Practice Address - Zip Code:26000
Practice Address - Country:PH
Practice Address - Phone:63074-445-7001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ04251966282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital