Provider Demographics
NPI:1093942617
Name:MENNONITE GENERAL HOSPITAL INC
Entity type:Organization
Organization Name:MENNONITE GENERAL HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING AND COLLECTION
Authorized Official - Prefix:
Authorized Official - First Name:LISSETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:VASQUEZ RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-434-1700
Mailing Address - Street 1:PO BOX 871
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-0871
Mailing Address - Country:US
Mailing Address - Phone:787-714-2462
Mailing Address - Fax:787-735-3233
Practice Address - Street 1:CARRETERA 14 INTERIOR 15
Practice Address - Street 2:CALLE SARGENTO GERARDO SANTIAGO
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-0871
Practice Address - Country:US
Practice Address - Phone:787-714-2462
Practice Address - Fax:787-735-3233
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MENNONITE GENERAL HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-22
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital