Healthcare Provider Details

I. General information

NPI: 1972503647
Provider Name (Legal Business Name): GOVERNOR JUAN F. LUIS HOSPITAL & MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#4007 ESTATE DIAMOND RUBY
CHRISTIANSTED, ST. CROIX VI
00821-4421
US

IV. Provider business mailing address

#4007 ESTATE DIAMOND RUBY
CHRISTIANSTED, ST. CROIX VI
00821-4421
US

V. Phone/Fax

Practice location:
  • Phone: 340-778-6311
  • Fax: 340-772-7357
Mailing address:
  • Phone: 340-778-6311
  • Fax: 340-772-7357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. GREGORY J. CALLISTE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: PHD,FACHE
Phone: 340-778-6311