Provider Demographics
NPI:1871255810
Name:RIBERAS MEDICAL CENTER
Entity Type:Organization
Organization Name:RIBERAS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:331-071-5051
Mailing Address - Street 1:RIBERAS MEDICAL CENTER
Mailing Address - Street 2:401 BROADWAY SUITE 100 PMB 92678
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:RIBERAS MEDICAL CENTER
Practice Address - Street 2:LIBRAMIENTO CARRETERA 153
Practice Address - City:CHAPALA
Practice Address - State:JALISCO
Practice Address - Zip Code:45922
Practice Address - Country:MX
Practice Address - Phone:331-071-5051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PEJ345487OtherSTATE