MEDICARE: PRESBYTERIAN COMMUNITY HOSPITAL, 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	291U00000X	Clinical Medical Laboratory
2	333600000X	Pharmacy
3	261QA1903X	Ambulatory Surgical Clinic/Center
4	261QE0002X	Emergency Care Clinic/Center
5	261QE0800X	Endoscopy Clinic/Center
6	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center
7	261QP2000X	Physical Therapy Clinic/Center
8	261QR0200X	Radiology Clinic/Center
9	261QR0206X	Mammography Clinic/Center
10	207U00000X	Nuclear Medicine Physician
11	282N00000X	General Acute Care Hospital	61	PR

General Provider Information

NPI Number	:	1770580813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESBYTERIAN COMMUNITY HOSPITAL, INC

Provider Business Mailing Address
First Line	:	PO BOX 9020032
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00902-0032
Country	:	US
Telephone Number	:	787-721-2160
Fax Number	:	787-723-3797

Provider Business Practice Location Address
First Line	:	1451 ASHFORD
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1511
Country	:	US
Telephone Number	:	787-721-2160
Fax Number	:	787-723-3797

Authorized Official
Title or Position	:	BILLING SUPERVISOR
Name	:	SARAHI DELVALLE GONZALEZ
Credential	:
Telephone Number	:	787-721-2160

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	07/23/2024

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