Provider Demographics
NPI:1669509907
Name:HOSPITAL SANTA ROSA
Entity Type:Organization
Organization Name:HOSPITAL SANTA ROSA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LCDA. GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ VILA
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:1787-866-5007
Mailing Address - Street 1:PO BOX 10008
Mailing Address - Street 2:SAME
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-4008
Mailing Address - Country:US
Mailing Address - Phone:787-864-0101
Mailing Address - Fax:
Practice Address - Street 1:LOS VETERANOS AVE ROAD NO 3
Practice Address - Street 2:SALIDA HACIA ARROYO
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00785
Practice Address - Country:US
Practice Address - Phone:787-864-0101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy