Provider Demographics
NPI:1831194729
Name:SOUTHWEST HEALTH CORP
Entity type:Organization
Organization Name:SOUTHWEST HEALTH CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:LOURDES
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-650-0020
Mailing Address - Street 1:PO BOX 9976
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-9976
Mailing Address - Country:US
Mailing Address - Phone:787-650-0020
Mailing Address - Fax:787-650-0098
Practice Address - Street 1:ZONA INDUSTRIAL VICTOR ROJAS II
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-650-0020
Practice Address - Fax:787-650-0098
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHWEST HEALTH CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-16
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR40261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care