NPIMap

Organization Active NPI

Southern Hospital Service Inc

Doing business as Centro San Cristobal Villalba

  • Multi-Specialty Clinic/Center
  • Villalba, PR
National Provider Identifier
1790804680
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
SOUTHERN HOSPITAL SERVICE INC
Doing business as
Centro San Cristobal Villalba
Practice address
40 Calle Munoz Rivera
Villalba, PR 00766-2221
Phone
(787) 847-3000
Fax
(787) 260-1441
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Franco Soldevila
Title
Accountant
Phone
(787) 837-2265

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X
Multi-Specialty Clinic/Center 261QM1300X Primary
Primary Care Clinic/Center 261QP2300X
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

40 Calle Munoz Rivera
Villalba, PR 00766-2221

Mailing address

PO Box 1400
Juana Diaz, PR 00795-1400
Phone (787) 837-2265

Other identifiers 1

IdentifierTypeStateIssuer
CN020AOtherPRPTAN

Other names 1

  • CENTRO SAN CRISTOBAL VILLALBA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051221000942 PR Part B Supplier - Clinic/Group Practice 6709847239 Receives reassigned benefits from 3 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coto Laurel, PR; Juana Diaz, PR; Santa Isabel, PR; Villalba, PR

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Centro San Cristobal12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

40 Calle Munoz Rivera
Villalba, PR 00766
Phone (787) 847-3000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481673600000",
    "number": "1790804680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1400",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "007951400",
            "telephone_number": "787-837-2265",
            "fax_number": "787-260-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CALLE MUNOZ RIVERA",
            "city": "VILLALBA",
            "state": "PR",
            "postal_code": "007662221",
            "telephone_number": "787-847-3000",
            "fax_number": "787-260-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN HOSPITAL SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2016-12-14",
        "status": "A",
        "authorized_official_last_name": "SOLDEVILA",
        "authorized_official_first_name": "FRANCO",
        "authorized_official_title_or_position": "ACCOUNTANT",
        "authorized_official_telephone_number": "787-837-2265",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "CN020A",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTRO SAN CRISTOBAL VILLALBA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Villalba, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.