Provider Demographics
NPI:1336248947
Name:HOSPITAL SANTA ROSA INC
Entity Type:Organization
Organization Name:HOSPITAL SANTA ROSA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ VILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-864-0810
Mailing Address - Street 1:PO BOX 10008
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785
Mailing Address - Country:US
Mailing Address - Phone:787-864-0101
Mailing Address - Fax:787-866-0489
Practice Address - Street 1:AVE LOS VETERANOS CARR 3 SALIDA HACIA ARROYO
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-864-0101
Practice Address - Fax:787-866-0489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRLICENSE39282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
17034SAOtherSSS DED
10034SAOtherSSS HOSP
18034SAOtherSSS CIR AMB
1169OtherIMC
30083SAOtherSSS OPD
030131OtherLA CRUZ AZUL DE PR
5000181OtherACAA EMER Y ANCILARES
73501OtherFSE
FH0604OtherUIA
H301OtherPLAN DE SALUD MENONITA
19034SAOtherSSS EMERG
0120596OtherACAA COMP MEDICO
300041OtherPREFERRED HEALTH
5000181OtherACAA HOSP
6540001OtherHUMANA HEALTH INS
H301OtherPLAN DE SALUD MENONITA
030131OtherLA CRUZ AZUL DE PR