Provider Demographics
NPI:1194966424
Name:INTEGRATE COMMUNITY HEALTH SYSTEM, INC.
Entity type:Organization
Organization Name:INTEGRATE COMMUNITY HEALTH SYSTEM, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-641-4234
Mailing Address - Street 1:CARR. #3 KM 13.4 BO. CANOVANILLAS
Mailing Address - Street 2:FIRST MEDICAL BUILDING
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985
Mailing Address - Country:US
Mailing Address - Phone:787-993-4990
Mailing Address - Fax:787-993-4994
Practice Address - Street 1:400 CALAF STREET PMB 455
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1314
Practice Address - Country:US
Practice Address - Phone:787-641-4234
Practice Address - Fax:787-274-8895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental