- Enrollment id
- O20080201000303
- Enrollment state
- PR
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1346447265
- Multiple npi flag
- N
- Ccn
- 401567
- Associate id
- 5496837296
- Organization name
- MED HEALTH HOSPICE CORP
- Doing business as name
- LAM MEDICAL SERVICE
- Incorporation date
- 2003-04-09
- Incorporation state
- PR
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- CARR 102 KM 18.6
- Address line 2
- BO PARABUELLON
- City
- CABO ROJO
- State
- PR
- Zip code
- 006233138