Provider Demographics
NPI:1205978616
Name:MIGRANT HEALTH CENTER WESTERN REGION,INC
Entity type:Organization
Organization Name:MIGRANT HEALTH CENTER WESTERN REGION,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTORA EJECUTIVA
Authorized Official - Prefix:DR
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:RODRIGUEZ
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-805-2900
Mailing Address - Street 1:P.O. BOX 190
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681
Mailing Address - Country:US
Mailing Address - Phone:787-805-2900
Mailing Address - Fax:787-834-1924
Practice Address - Street 1:CALLE RAMON EMETERIO BENTANCES #497 COND BLDG
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-1714
Practice Address - Country:US
Practice Address - Phone:787-805-2900
Practice Address - Fax:787-265-4245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR860291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR31095OtherNUMERO GRUPAL SSS
PR=========OtherNUM PATRONAL
PR0030983Medicare ID - Type UnspecifiedNUMERO GRUPAL