Provider Demographics
NPI:1366266645
Name:HOSPITAL MARIA DE LOURDES
Entity type:Organization
Organization Name:HOSPITAL MARIA DE LOURDES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:EZQUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-449-7799
Mailing Address - Street 1:HOSPITAL MARIA DE LOURDES
Mailing Address - Street 2:500 WESTOVER DR #34365
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330
Mailing Address - Country:US
Mailing Address - Phone:888-449-7799
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL MARIA DE LOURDES
Practice Address - Street 2:1 PONIENTE SECTOR JUAREZ
Practice Address - City:PUERTO ESCONDIDO
Practice Address - State:OAXACA
Practice Address - Zip Code:71984
Practice Address - Country:MX
Practice Address - Phone:888-449-7799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital