# MENNONITE GENERAL HOSPITAL INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Centro de Cuidado de Heridas y Ulceras Menonita
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225707078
- **Authorized official:** LISSETTE VASQUEZ RIVERA (DIRECTOR OF BILLING AND COLLECTOR)
- **Authorized official phone:** (787) 434-1700

## Contact information

- **Practice address:** CALLE JOSE C VAZQUEZ INTERIOR, BO CAONILLAS, AIBONITO, PR 00705-1379
- **Practice address phone:** (787) 434-1700
- **Practice address fax:** (787) 434-1711
- **Mailing address:** PO BOX 1650, CIDRA, PR 00739-1650
- **Mailing address phone:** (787) 434-1700
- **Mailing address fax:** (787) 434-1711

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/07/2021
- **Last updated:** 09/07/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 037681100 | — | PR |