Provider Demographics
NPI:1912108226
Name:WESTERN HYPERBARIC SERVICES
Entity Type:Organization
Organization Name:WESTERN HYPERBARIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:SOSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-696-0014
Mailing Address - Street 1:15 CALLE LUIS FELIPE DESSUS
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-1501
Mailing Address - Country:US
Mailing Address - Phone:787-260-8895
Mailing Address - Fax:
Practice Address - Street 1:CENTRO MEDICO DE MAYAGUEZ SUITE #1
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-831-0266
Practice Address - Fax:787-832-0653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR85055Medicare ID - Type UnspecifiedMEDICARE TRIPLE-S