Provider Demographics
NPI:1952405268
Name:HOSPITAL ANDRES GRILLASCA INC
Entity Type:Organization
Organization Name:HOSPITAL ANDRES GRILLASCA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT FINANCIAL SERVICE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HAEDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS BURGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-848-0800
Mailing Address - Street 1:PO BOX 331324
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00733-1324
Mailing Address - Country:US
Mailing Address - Phone:787-848-0800
Mailing Address - Fax:787-843-2310
Practice Address - Street 1:TITO CASTRO AVE CARR 14 BO MACHUELO
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00733-1324
Practice Address - Country:US
Practice Address - Phone:787-848-0800
Practice Address - Fax:787-843-2310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21CNC02196284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
400028Medicare ID - Type Unspecified