Provider Demographics
NPI:1952905374
Name:HEALTHCARE INTEGRATE PROGRAM SERVICES, INC.
Entity Type:Organization
Organization Name:HEALTHCARE INTEGRATE PROGRAM SERVICES, INC.
Other - Org Name:PROGRAMA CIS
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:PROF
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLENTINO RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-852-0768
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-0220
Mailing Address - Country:US
Mailing Address - Phone:787-852-0768
Mailing Address - Fax:787-716-7981
Practice Address - Street 1:355 CALLE FONT MARTELO
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3249
Practice Address - Country:US
Practice Address - Phone:787-852-0768
Practice Address - Fax:787-716-7981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-25
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy