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General NPI Number Information
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NPI Number | 1144613514
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Entity Type | Organization
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Legal Business Name | MENNONITE GENERAL HOSPITAL INC.
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Dates
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Enumeration Date | 03/10/2015
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Last Update Date | 03/10/2015
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Provider Practice Location Address
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Address Line | 4 CALLE DR TROYER URB VILLA ROSALES
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City | AIBONITO
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State | PR
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Zip | 00705-3304
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Country | US
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Telephone | 787-735-1955
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Fax | 787-735-1525
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Provider Business Mailing Address
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Address Line | PO BOX 1379
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City | AIBONITO
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State | PR
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Zip | 00705-1379
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Country | US
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Telephone | 787-735-1955
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Fax | 787-735-1525
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Authorized Official
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Title or Position | CHIEF OPERATONG OFFICER (COO)
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Name | MARTA R MERCADO
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Credential |
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Telephone | 787-535-1001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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