Provider Demographics
NPI:1720227952
Name:DOCTORS CENTER HOSPITAL ARECIBO INC
Entity Type:Organization
Organization Name:DOCTORS CENTER HOSPITAL ARECIBO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRADOR
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA LUGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1787-854-3322
Mailing Address - Street 1:PO BOX 30532
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-8513
Mailing Address - Country:US
Mailing Address - Phone:787-854-3322
Mailing Address - Fax:787-884-3307
Practice Address - Street 1:CARR. #2 KM 80.1
Practice Address - Street 2:BO SAN DANIEL
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-854-3322
Practice Address - Fax:787-884-3307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR708291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0085470Medicare Oscar/Certification