Provider Demographics
NPI:1912942384
Name:COMMUNITY PRIMARY HEALTH, INC
Entity Type:Organization
Organization Name:COMMUNITY PRIMARY HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANIBAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-877-1588
Mailing Address - Street 1:227 CALLE OBISPADO
Mailing Address - Street 2:BO. MIRADERO
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-7702
Mailing Address - Country:US
Mailing Address - Phone:787-877-1588
Mailing Address - Fax:787-264-3440
Practice Address - Street 1:CARR. #111 KM 6.3
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-877-1588
Practice Address - Fax:787-264-3440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health