Provider Demographics
NPI:1447665062
Name:SALA DE URGENCIAS CDT VILLA LOS SANTOS
Entity type:Organization
Organization Name:SALA DE URGENCIAS CDT VILLA LOS SANTOS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1787-817-3144
Mailing Address - Street 1:PO BOX 9980
Mailing Address - Street 2:COTTO STATION
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-9980
Mailing Address - Country:US
Mailing Address - Phone:787-879-1585
Mailing Address - Fax:787-816-7284
Practice Address - Street 1:V1 CALLE 16
Practice Address - Street 2:URBANIZACION VILLA LOS SANTOS
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-3112
Practice Address - Country:US
Practice Address - Phone:787-879-1585
Practice Address - Fax:787-816-7284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care