Healthcare Provider Details

I. General information

NPI: 1063178283
Provider Name (Legal Business Name): HOSPITAL SANTA MARIA CHAPALITA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2021
Last Update Date: 11/11/2021
Certification Date: 10/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL SANTA MARIA CHAPALITA AV NINO OBRERO 1666
ZAPOPAN JALISCO
45040
MX

IV. Provider business mailing address

HOSPITAL SANTA MARIA CHAPALITA 1445 WOODMONT LANE NW #2279
ATLANTA GA
30318
US

V. Phone/Fax

Practice location:
  • Phone: 333-678-1400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELVIRA ARANDA MARTINEZ
Title or Position: MGR
Credential: MGR
Phone: 333-678-1400