Provider Demographics
NPI:1760437206
Name:HOSPICIO DEL OESTE, INC.
Entity Type:Organization
Organization Name:HOSPICIO DEL OESTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANIBAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-892-1820
Mailing Address - Street 1:227 CALLE OBISPADO
Mailing Address - Street 2:BO. MIRADERO
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-7702
Mailing Address - Country:US
Mailing Address - Phone:787-892-1820
Mailing Address - Fax:787-264-3440
Practice Address - Street 1:CARR. #2 KM 170.9
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-9732
Practice Address - Country:US
Practice Address - Phone:787-892-1820
Practice Address - Fax:787-264-3440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR40-1520Medicare ID - Type UnspecifiedHOSPICE PROVIDER