Provider Demographics
NPI:1144964867
Name:SHC OWNER LLC
Entity type:Organization
Organization Name:SHC OWNER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:MARCIAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-625-5050
Mailing Address - Street 1:PO BOX 30532
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-8513
Mailing Address - Country:US
Mailing Address - Phone:787-625-5050
Mailing Address - Fax:787-625-3030
Practice Address - Street 1:ROAD 696 #900
Practice Address - Street 2:INTERSECTION, AVE EFRON, BO. HIGUILLAR,
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-625-5050
Practice Address - Fax:787-625-3030
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHC OWNER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health