Provider Demographics
NPI:1891799763
Name:THE ST THOMAS EAST END MEDICAL CENTER CORPORATION
Entity type:Organization
Organization Name:THE ST THOMAS EAST END MEDICAL CENTER CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TESS
Authorized Official - Middle Name:G
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:340-775-3700
Mailing Address - Street 1:PO BOX 503177
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00805-3177
Mailing Address - Country:US
Mailing Address - Phone:340-775-3700
Mailing Address - Fax:340-777-7927
Practice Address - Street 1:4605 TUTU PARK MALL
Practice Address - Street 2:SUITE 207
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-775-3700
Practice Address - Fax:340-777-7927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0904XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, Federal
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI481802Medicare PIN