Provider Demographics
NPI:1063435782
Name:SOUTHWEST HEALTH CORP.
Entity type:Organization
Organization Name:SOUTHWEST HEALTH CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:A
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-892-4242
Mailing Address - Street 1:8 CALLE JAVILLA
Mailing Address - Street 2:AL COSTADO ANTIGUO PARQUE DE BOMBAS
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-4102
Mailing Address - Country:US
Mailing Address - Phone:787-892-5300
Mailing Address - Fax:787-892-1362
Practice Address - Street 1:8 CALLE JAVILLA
Practice Address - Street 2:AL COSTADO ANTIGUO PARQUE DE BOMBAS
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4102
Practice Address - Country:US
Practice Address - Phone:787-892-5300
Practice Address - Fax:787-892-1362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR400126OtherMEDICARE