Provider Demographics
NPI:1336406925
Name:HOSPITAL DE LA CONCEPCION INC
Entity Type:Organization
Organization Name:HOSPITAL DE LA CONCEPCION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRADORA
Authorized Official - Prefix:MR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CRESPO
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-892-1860
Mailing Address - Street 1:PO BOX 285
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-0285
Mailing Address - Country:US
Mailing Address - Phone:787-892-1860
Mailing Address - Fax:787-264-7908
Practice Address - Street 1:RD #2 BO. CAIN ALTO
Practice Address - Street 2:KM 173.4
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-0000
Practice Address - Country:US
Practice Address - Phone:787-892-1860
Practice Address - Fax:787-264-7908
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPITAL DE LA CONCEPCION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-19
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR57273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherCOMMERCIAL PLANS