MEDICARE: SOUTHWEST HEALTH CORP.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital	22	PR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	400126	OTHER	PR	MEDICARE

General Provider Information

NPI Number	:	1063435782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST HEALTH CORP.

Provider Business Mailing Address
First Line	:	8 CALLE JAVILLA
Second Line	:	AL COSTADO ANTIGUO PARQUE DE BOMBAS
City	:	SAN GERMAN
State	:	PR
Zip	:	00683-4102
Country	:	US
Telephone Number	:	787-892-5300
Fax Number	:	787-892-1362

Provider Business Practice Location Address
First Line	:	8 CALLE JAVILLA
Second Line	:	AL COSTADO ANTIGUO PARQUE DE BOMBAS
City	:	SAN GERMAN
State	:	PR
Zip	:	00683-4102
Country	:	US
Telephone Number	:	787-892-5300
Fax Number	:	787-892-1362

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. MARCO A REYES
Credential	:	MHSA
Telephone Number	:	787-892-4242

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	01/20/2016

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Directions to “SOUTHWEST HEALTH CORP. ” Practice Location

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