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NPI Code Detail

MEDICARE: ST LUKES EPISCOPAL CHURCH HOME CARE PROGRAM

MEDICARE: ST LUKES EPISCOPAL CHURCH HOME CARE PROGRAM
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
1251E00000XHome Health Agency35PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1071002OTHERPRCRUZ AZUL
21-9485STOTHERPRTRIPLE S
39800093OTHERPRACAA
47330102OTHERPRHUMANA

General Provider Information

NPI Number : 1639163827
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST LUKES EPISCOPAL CHURCH HOME CARE PROGRAM
Provider Business Mailing Address
First Line : APARTADO 1809 VICTORIA STATION
Second Line :
City : AGUADILLA
State : PR
Zip : 00605
Country : US
Telephone Number : 787-843-4185
Fax Number : 787-843-5850
Provider Business Practice Location Address
First Line : CARR. #2 KM. 124.9
Second Line : BO. CAIMITAL BAJO
City : AGUADILLA
State : PR
Zip : 00605
Country : US
Telephone Number : 787-843-4185
Fax Number : 787-843-5850
Authorized Official
Title or Position : OPERATIONAL EXECUTIVE DIRECTOR
Name : MS. ISUANET CASTILLO
Credential : CPA
Telephone Number : 787-843-4185
Provider Enumeration Date : 09/02/2005
Last Update Date : 12/16/2011

Similar Medicare Providers

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Practice Fax:
1013901123 — ST LUKES EPISCOPAL CHURCH HOME CARE PROGRAM
Practice Location Address:
CARR #2 KM 124.9 , BO CIMITAL BAJO
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1720062144 — DR. JAIME J DASILVA AROCHO
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1710962204 — RICARDO E. SANTIAGO M.D
Practice Location Address:
LOBBY HOSPITAL BUEN SAMARITANO , AVE SEVERIANO CUEVAS 18
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1164408944 — DR. CARLOS ROBERTO MARQUEZ - TORO M.D.
Practice Location Address:
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Practice Fax: 787-805-7495

Directions to “ST LUKES EPISCOPAL CHURCH HOME CARE PROGRAM ” Practice Location

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