Provider Demographics
NPI:1265409791
Name:HOSPITAL DAMAS INC
Entity type:Organization
Organization Name:HOSPITAL DAMAS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GERENTE CONTRATACION Y COBROS
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BONILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-840-8686
Mailing Address - Street 1:286 CALLE MONTERREY
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-0377
Mailing Address - Country:US
Mailing Address - Phone:787-840-8686
Mailing Address - Fax:787-259-7364
Practice Address - Street 1:2213 PONCE BY PASS
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1318
Practice Address - Country:US
Practice Address - Phone:787-840-8686
Practice Address - Fax:787-259-7364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-03
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR05305251E00000X
PR9251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR407010Medicare PIN
PR407010Medicare UPIN
PR407010Medicare Oscar/Certification