- Enrollment id
- O20130517000161
- Enrollment state
- PR
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1639113301
- Multiple npi flag
- N
- Ccn
- 401561
- Associate id
- 1557508249
- Organization name
- WESTERN MEDICAL HOSPICE, INC.
- Incorporation date
- 2000-08-01
- Incorporation state
- PR
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- CALLE B LOTE 30 # 4040
- Address line 2
- ZONA INDUSTRIAL GUANAJIBO, SUITE 4
- City
- MAYAGUEZ
- State
- PR
- Zip code
- 006821378