Provider Demographics
NPI:1790788222
Name:SANTA MARIA MEDICAL SERVIES INC
Entity Type:Organization
Organization Name:SANTA MARIA MEDICAL SERVIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:I
Authorized Official - Last Name:GRAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-841-4400
Mailing Address - Street 1:PO BOX 8335
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-8335
Mailing Address - Country:US
Mailing Address - Phone:787-841-4400
Mailing Address - Fax:787-841-4400
Practice Address - Street 1:1575 AVE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0211
Practice Address - Country:US
Practice Address - Phone:787-841-4400
Practice Address - Fax:787-841-4400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition