Provider Demographics
NPI:1922034776
Name:HOSPITAL COMUNITARIO BUEN SAMARITANO INC
Entity type:Organization
Organization Name:HOSPITAL COMUNITARIO BUEN SAMARITANO INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEVES ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-658-0000
Mailing Address - Street 1:PO BOX 4055
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-4055
Mailing Address - Country:US
Mailing Address - Phone:787-658-0000
Mailing Address - Fax:787-658-0682
Practice Address - Street 1:CARR. EST. PR-460, KM. 0.2
Practice Address - Street 2:BO CAIMITAL BAJO
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-819-0955
Practice Address - Fax:787-658-0682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR982A282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR400079Medicare PIN
PRHX720AMedicare PIN