Provider Demographics
NPI:1841295557
Name:SAINT LUKES MEMORIAL HOSPITAL INC
Entity type:Organization
Organization Name:SAINT LUKES MEMORIAL HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILLEN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:787-844-2080
Mailing Address - Street 1:PO BOX 336810
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00733-6810
Mailing Address - Country:US
Mailing Address - Phone:787-844-2080
Mailing Address - Fax:787-844-7506
Practice Address - Street 1:917 AVE TITO CASTRO
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-4717
Practice Address - Country:US
Practice Address - Phone:787-844-2080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-17
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
273R00000X
PR5282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR10826OtherTRIPLE S
PR660191960OtherMAPFRE & OTHERS
PR19020OtherTRIPLE S
PR19826OtherTRIPLE S
PR7310370OtherHUMANA
PR31225OtherTRIPLE S
PR31247OtherTRIPLE S
PR5501466OtherACAA ASC
PR92399OtherTRIPLE S
PR18826OtherTRIPLE S
PR300115OtherUTI
PR304264OtherACAA TERAPIA FISICA
PR18020OtherTRIPLE S
PR4855OtherIMC
PR66011960BOtherMCS
PR700009OtherMMM
PR31225OtherTRIPLE C
PR5001587OtherACAA HOSP/ER
PR19826OtherTRIPLE S
PR7310370OtherHUMANA