Provider Demographics
NPI:1760968960
Name:SAINT LUKES MEMORIAL HOSPITAL INC
Entity Type:Organization
Organization Name:SAINT LUKES MEMORIAL HOSPITAL INC
Other - Org Name:CENTRO DE SALUD FAMILIAR SAN LUCAS GO-GOGO
Other - Org Type:Other Name
Authorized Official - Title/Position:EHR PROJECT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-844-2080
Mailing Address - Street 1:PO BOX 336810
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00733-6810
Mailing Address - Country:US
Mailing Address - Phone:787-844-2080
Mailing Address - Fax:787-844-2090
Practice Address - Street 1:URB INDUSTRIAL REPARADA 291
Practice Address - Street 2:B CALLE MONTERREY BO CANAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00733
Practice Address - Country:US
Practice Address - Phone:787-844-2080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT LUKES MEMORIAL HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR147261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care