MEDICARE: QUALITY HEALTH SERVICES OF PUERTO RICO INC

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	17	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568476539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY HEALTH SERVICES OF PUERTO RICO INC

Provider Business Mailing Address
First Line	:	PO BOX 800501
Second Line	:
City	:	COTO LAUREL
State	:	PR
Zip	:	00780-0501
Country	:	US
Telephone Number	:	787-848-2100
Fax Number	:	787-848-1110

Provider Business Practice Location Address
First Line	:	PR 506 STREET
Second Line	:	KM 1.0
City	:	COTO LAUREL
State	:	PR
Zip	:	00780-0501
Country	:	US
Telephone Number	:	787-848-2100
Fax Number	:	787-848-1110

Authorized Official
Title or Position	:	SENIOR EXECUTIVE & VP
Name	:	PEDRO L BENETTI
Credential	:
Telephone Number	:	787-848-2100

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	06/07/2011

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