Provider Demographics
NPI:1811705676
Name:HOSPITAL REAL SAN LUCAS OF MEXICO
Entity type:Organization
Organization Name:HOSPITAL REAL SAN LUCAS OF MEXICO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GELBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-640-2227
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-0220
Mailing Address - Country:US
Mailing Address - Phone:732-640-2227
Mailing Address - Fax:732-640-2230
Practice Address - Street 1:AV LUIS DONALDOCOLOCIO 863
Practice Address - Street 2:
Practice Address - City:LA GLORIA TEPATITLAN DE MORALES
Practice Address - State:JALISCO
Practice Address - Zip Code:47670
Practice Address - Country:MX
Practice Address - Phone:378-688-1829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital