Provider Demographics
NPI:1104070044
Name:OUR LADY OF PURIFICACION DOCTORS HOSPITAL,INC.
Entity type:Organization
Organization Name:OUR LADY OF PURIFICACION DOCTORS HOSPITAL,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FAITH AMORFINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUBIDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:63074-445-7001
Mailing Address - Street 1:SUITE 410, MT. CREST HOTEL LEGARDA ROAD
Mailing Address - Street 2:
Mailing Address - City:BAGUIO CITY
Mailing Address - State:PHILIPPINES
Mailing Address - Zip Code:26000
Mailing Address - Country:PH
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:POBLACION BINMALEY
Practice Address - Street 2:
Practice Address - City:PANGASINAN
Practice Address - State:REGION 1
Practice Address - Zip Code:24000
Practice Address - Country:PH
Practice Address - Phone:63074-445-7001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
04251966Medicare PIN