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Halaman :
Tanggal :
1/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/03/022012
01/03/2012
28/02/2013
7000
PER/01/012012
01/01/2012
31/12/2012
5000
PER/02/022012
01/03/2012
28/02/2013
10000
PER/01/012012
01/01/2012
31/12/2012
5000
PER/09/062012
01/07/2012
30/06/2013
7000
PER/08/062012
01/07/2012
30/06/2013
7000
DR I KOMANG SUWIRTA
PER/11/062012
01/07/2012
30/06/2013
5000
DR M RAMDHANI
PER/07/04212
01/05/2012
30/04/2013
5000
97661
DR NY K NOTANUBUN, M.KES
PER/17/082012
01/09/2012
31/08/2013
5000
97111
DR SINTJE TJENGNIS
PER/01/012013
01/01/2013
31/12/2013
97114
PER/37/122011
01/01/2012
31/12/2012
5000
JL PALA NO 2 RT003/002
97111
PER/14/062012
01/07/2012
30/06/2013
5000
02424
0911-341004
97122
PER/12/062012
01/07/2012
30/06/2013
7000
14
05599
JL WAILOLA - BULA
0915-21392
97553
DR I KOMANG SUWIRTA
PER/10/062012
01/07/2012
30/06/2013
3000
15
07420
97661
IDA RAHAIL
01/07/2012
30/06/2013
5000
16
07421
0911-362512
97111
0911-362810
PER/05/042012
01/04/2012
31/03/2013
5000
17
04716
0911-342746
97111
PER/12/062012
01/08/2012
31/07/2013
7000
18
04713
0911-353008
97111
YAYASAN AL FATAH
PER/36/122011
01/01/2012
31/12/2012
7000
19
02425
RSUD DR M HAULUSSY
JL DR KAYADOE NO AMBON
0911-344871
97116
PEMDA MALUKU
PER/03/022012
01/03/2012
28/02/2013
10000
20
07718
97553
PE/01/012012
01/01/2012
31/12/2012
5000
21
05448
JL WAILOLA
0915-21392
97553
DR I KOMANG SUWIRTA
PER/10/062012
01/07/2012
30/06/2013
1000
22
07419
97661
IDA RAHALAIL
PER/19/092012
01/07/2012
30/06/2013
5000
23
07327
RS HATIVE - PASSO
0911-362512
97111
PER/05/042012
01/04/2012
31/03/2013
7000
24
03800
0911-353008
97114
PER/36/122011
01/01/2012
31/12/2012
7000
25
02426
0911-342746
97114
PER/12/062012
01/08/2012
31/07/2013
7000
26
02429
JL DR KAYADOE
97116
PER/16/082012
01/08/2012
31/07/2013
7000
06167
JL DR KAYADOE
97116
PEMDA MALUKU
07717
97553
06100
JL DR KAYADOE
97116
PEMDA MALUKU
07716
POLI SALIN RSUD KAB SERAM BAGIAN TIMUR BULA - SERAM BAGIAN TIMUR
97553
03799
JL AM SANGAJI NO 36 AMBON
0911-312779
97114
02423
DR CHRISS RELMASIRA
0911-351654
97124
DR CHRIS RELMASIRA
05449
DR I KOMANG SUWIRTA
JL WAILOLA X BULA
0852-43346068 97553
06694
DR M RAMDHANI
JL. FLAMBOYAN
97371
06855
DR NY K NOTANUBUN, M.KES
10
07326
DR SINTJE TJENGNIS
11
07514
12
06856
13
5000
RI244010
PKR102001
Halaman :
Tanggal :
2/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
27
07418
APOTEK BERKAT
97111
28
07417
APOTEK GRACE
97661
29
08020
APOTEK RAJAWALI
0911-352137
30
04715
31
07422
32
02430
OPTIK SEHATI
RI244010
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/13/062012
01/07/2012
30/06/2013
PER/04/042012
01/04/2012
31/03/2013
5000
PER/09/062012
01/07/2012
30/06/2013
5000
PER/15/082012
01/08/2012
31/07/2013
700
PER/06/052012
01/05/2012
30/04/2013
5000
PER/18/092012
01/08/2011
31/07/2013
7000
WINA TANY
LILI TALAUD
97124
0911-342014
97111
JL. FLAMBOYAN
0913-21101
97371
JL DIPONEGORO
0911-342387
97114
MEDIANA ALKATIRI
HARI BUKA
PPK II
PKR102001
Halaman :
Tanggal :
3/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
07721
JL. TRANS HALUT SAMPING TERMINAL BARU WOSIA TOBELO 0924-2621903 95372
TENGAH APOTEK ANUGERAH
05391
JL LANDBOUW TOBELO
0924-21566
95372
0924-21665
06314
092108124434865
95372
02416
DR TUTHANURANI NACHRAWY
JL PAHLAWAN REVOLUSI
0921-24601
97792
0921-24601
08105
97756
07907
07316
DRG.DHANNY S ARIESVIANTO
03251
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/09/042012
01/05/2012
30/04/2013
1000
15/12/2007
14/12/2008
3000
PER/16/072012
01/09/2012
31/08/2013
7000
DR.TUTHANURANI NACHARAWI
PER/11/042012
01/05/2012
30/04/2013
PER/18/102012
01/11/2012
31/12/2013
1000
95372
DRG. A. M. CHAERUDDIN. K, M.
KES
PER/20/102012
01/10/2012
31/12/2013
1000
-081281065492 97792
DRG.DHANNY STEFFANS
ARIESVIANTO
PER/14/052012
01/06/2012
31/05/2013
RSU TERNATE
0921-21281
97715
0921-21777
PEMPROV MALUT
PER/12/042012
01/07/2012
30/06/2013
7000
05392
RSUD TOBELO
0924-21566
95372
0924-21665
PEMKAB HALUT
PER/07/022012
01/03/2012
28/02/2013
3000
10
08016
0924-21118
97756
PER/17/082012
01/10/2012
31/12/2013
7500
11
08106
97853
PEMDA
PER/19/102012
01/11/2012
31/12/2013
2500
12
06574
RUMAH SAKIT ISLAM BINA WARGA TERNATE JLN.PEMUDA NO.131 KOTA TERNATE
0921-3121623 97792
PER/06/022012
01/03/2012
28/02/2013
7000
13
02419
0921-23076
97792
0921-23076
PT.KIMIA FARMA
PER/10/042012
01/05/2012
30/04/2013
7000
14
07451
0924-2621665 95372
0924-21665
PER/15/072012
01/08/2012
31/07/2013
7000
15
06557
0921-3121623 97792
16
02418
APOTIK RAKYAT
0921-21766
0921-21766
17
05414
OPTIK INTERNATIONAL
0921-3123424 97792
18
02420
OPTIK MANADO
0921-3121239 97792
BENYAMIN THE
RI244010
97792
PEMKAB HALUT
v
v
v
7000
7000
PER/05/022012
01/03/2012
28/02/2013
7000
PER/003/022012
01/02/2012
31/01/2013
7000
PER/002/022012
01/02/2012
31/01/2013
3000
PER/04/022012
01/02/2012
31/01/2013
7000
PKR102001
Halaman :
Tanggal :
4/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
06952
0951-321658
95772
0951-323496
07762
DR ADHE ISMAWAN
0986-211373
95355
DR ADHE ISMAWAN
04582
DR EVELINA
-NULL
95882
05347
95772
05231
DR HE SIHOMBING
06667
DR IDEHAM SAID
JL PENDIDIKAN K 8 SORONG
07855
05505
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/002/012013
01/01/2013
31/12/2013
PER/001/02/2012
20/02/2012
31/12/2012
DR EVELINA
PER/005/012013
01/01/2013
31/12/2013
7000
DR FREZZY
PER/006/012013
01/01/2013
31/12/2013
5000
95852
DR HE SIHOMBING
PER/003/012013
01/01/2013
31/12/2013
7000
95752
DR IDEHAM SAID
PER/001/072012
01/07/2012
01/07/2013
7000
JL BHAYANGKARA NO 01 MANOKWARI
95351
DR IWAN P
PER/013/012013
01/01/2013
31/12/2013
5000
DR LIDIA KURNIAWAN
0951-322723
95752
DR LIDIA KURNIAWAN
PER/009/012013
01/01/2013
31/12/2013
7000
02437
DR P RUSSEL SUPIT
0951-
95752
DR P RUSSEL SUPIT
PER/008/012013
01/01/2013
31/12/2013
7000
10
02901
DR RUSTIARI DATA
-951-321607
96185
PER/004/012013
01/01/2013
31/12/2013
7000
11
05028
95752
PER/01/082012
01/08/2012
31/08/2013
7000
12
02438
DR.KARTINI
-951-321992
96183
PER/007/012013
01/01/2013
31/12/2013
7000
13
04526
JL KESEHATAN NO 37
-0951-32160
96185
PER/010/012013
01/01/2013
31/12/2013
7000
14
07763
95353
PER/023/022012
01/03/2012
31/12/2012
15
06721
95853
PER/011/012013
01/01/2013
31/12/2013
7000
16
05670
96185
PER/012/012013
01/01/2013
31/12/2013
7000
17
06668
JL PENDIDIKAN KM 8 SORONG
95871
DR IDEHAM SAID
PER/002/072012
01/07/2012
30/06/2013
7000
18
05029
95752
PER/02/082012
01/08/2012
31/07/2013
7000
19
04525
-0951-322501 95763
PT HIP
PER/001/012013
01/01/2013
31/12/2013
7000
20
04655
0951-333666
H DJUMAIN AHMAD
PER/014/012013
01/01/2013
31/12/2013
7000
21
03942
22
03860
PPK1-REIMBURSE SORONG
-951-321580
23
02445
RS TK IV DR ARYOKO
JL PRAMUKA SORONG
-951-333708
95752
24
06911
MANOKWARI
95353
25
03941
RSAL DR OETOYO
95871
RI244010
95752
v
v
7000
7000
7000
7000
v
v
PER/005/072012
01/07/2012
30/06/2013
FASHARKAN TNI-AL
PER/019/012012
01/01/2012
31/12/2012
TNI-AL
PER/20/012012
01/01/2012
31/12/2012
7000
7000
PKR102001
Halaman :
Tanggal :
5/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
26
05671
96185
27
02442
RSUD SORONG
-951-321580
95763
28
04658
RS MUTIARA
JL MALEO NO 2 SORONG
-0951327433
96183
-0951332061
DR HJ PAHIMAH/ISKANDAR
29
02444
RSU HERLINA
-951-321424
95855
HUMALA SIHOMBING
30
02446
-951-321992
95764
31
06941
95774
KUMPUL BUKIT
32
02448
APOTIK MALEO
JL KESEHATAN NO37
0951-321607
96183
TELLY HARYADI
33
04656
95872
DRS A JUMAIN
34
02454
JL PERCETAKAN NO 4 MANOKWARI
-986-214477
35
04657
OPTICAL INTERNASIONAL
-0951328456
95882
36
02455
OPTIKAL SISWA
-951-321590
96185
37
02456
OPTIKAL SORONG
-951-332205
95752
38
03549
OPTIKAL SARJANA
-0951-321031
RI244010
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
31/12/2012
PER/019/012012
PER/018/012012
01/01/2012
31/12/2012
PER/026/012012
01/01/2012
31/12/2012
PER/004/122011
01/11/2012
31/12/2012
7000
PER/022/012012
01/01/2012
31/12/2012
7000
PER/023/012012
01/01/2012
31/12/2012
PER/026/012012
01/01/2012
31/12/2012
PER/027/012012
01/01/2012
31/12/2012
HARI BUKA
PPK II
7000
7000
7000
v
v
PER/018/012012
01/01/2012
31/12/2012
PENGKY TANERY
PER/016/012012
01/01/2012
31/12/2012
7000
YOUZAFITRA UTAMA
PER/017/012012
01/01/2012
31/12/2012
7000
7000
PKR102001
Halaman :
Tanggal :
6/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/23/102012
01/11/2012
31/10/2013
7000
PER/19/092012
01/10/2012
30/09/2013
7000
PER/19/092012
01/10/2012
30/09/2013
7000
PER/25/112012
01/12/2012
30/11/2013
3000
PER/18/092012
01/10/2012
30/09/2013
7000
DR ADE CAHYANI
PER/03/022012
01/03/2012
28/02/2013
8000
DR EVI TORIKI
PER/06/032012
01/04/2012
31/03/2013
7000
99352
DR SM SIAHAAN
PER/13/052012
01/06/2012
31/05/2013
7000
0811-4802644 97795
PER/12/052012
01/06/2012
31/05/2013
7000
97795
PER/01/012012
01/02/2012
31/01/2013
4000
-08124896167 97795
PER/21/102012
01/11/2012
31/10/2013
7000
97783
PER/16/082012
01/09/2012
31/08/2013
02474
JL CIKOMBONG ABEPURA
97795
PER/04/022012
01/03/2012
28/02/2013
7000
14
04660
-0811481339
97795
PER/22/102012
01/11/2012
31/10/2013
7000
15
04719
97795
PER/02/012012
01/02/2012
31/01/2013
10000
16
08063
97795
PER/20/102012
01/11/2012
31/10/2013
3000
17
08113
93563
PER/25/112012
01/12/2012
30/11/2013
4000
18
03509
0967-572123
97795
PER/05/022012
01/03/2012
28/02/2013
7000
19
02476
PPK1-RSUD JAYAPURA
-0967-533516
20
06925
0967-532146
97795
0967-522958
LANTAMAL X TNI AL
21
03487
RSUD JAYAPURA
0967-533516
97795
0967-533616
RSUD JAYAPURA
22
07561
RSUD MERAUKE
93563
RSUD MERAUKE
23
02905
0967-572123
97795
0967-573362
24
02478
-0967-523001 97795
25
05469
0967-572123
06924
0967-532146
97795
0967-522958
LANTAMAL X TNI AL
07559
93563
RSUD MERAUKE
07560
93563
RSUD MERAUKE
08113
93563
07558
-085244603533 93563
02472
DR ADE CAHYANI
JL SAMRATULANGI JAYAPURA
-08124801065 97795
02471
DR EVI TORIKI
-08124802303 97795
03998
DR SM SIAHAAN
05468
10
07039
11
05839
12
08008
13
v
v
v
v
7000
97795
3000
PER/23/102012
01/11/2012
31/10/2013
12000
PER/17/062012
01/07/2012
30/06/2013
7000
PER/19/092012
01/10/2012
30/09/2013
7000
PER/05/022012
01/03/2012
28/02/2013
7000
PER/08/032012
01/04/2012
31/03/2013
7000
PER/14/052012
01/06/2012
31/05/2013
7000
v
v
v
RI244010
PKR102001
Halaman :
Tanggal :
7/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
26
03999
APOTIK BUDI
99352
27
04720
APOTIK SEGAR
97795
28
02479
JL PERCETAKAN JAYAPURA
97795
RI244010
HARI BUKA
PPK II
S
RS
APT
HENNY M ISABELLA
ARNOLDUS JANSEN
AGUS NUKRISDIANTO
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/09/032012
01/04/2012
31/03/2013
7000
PER/24/102012
01/11/2012
31/10/2013
7000
PER/07/032012
01/04/2012
31/03/2013
7000
PKR102001
Halaman :
Tanggal :
8/239
15-01-2013
16:22:40
PEMILIK
NO
NO. PPK
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
07959
94352
07004
94352
07042
94352
04957
94352
07010
OPTIK INTERNASIONAL
0901-323770
94352
0901-323770
RI244010
RS
APT
v
v
v
NO IKS
JUMLAH
TTG
PER/02/122012
01/01/2013
31/12/2013
20000
PER/04/122012
01/01/2013
31/12/2013
10000
PER/04/122012
01/01/2013
31/12/2013
10000
PER/04/082012
01/08/2012
31/12/2013
7000
PER/05/052012
01/06/2012
30/06/2013
3000
v
v
POLA PEMBIAYAAN
JAM BUKA
v
LINGGARJANTO B.O
HARI BUKA
PPK II
PKR102001
Halaman :
Tanggal :
9/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/18/052012
01/06/2012
31/05/2013
15000
PER/15/052012
01/06/2012
31/05/2013
7000
PER/41/112012
01/12/2012
30/11/2013
2000
PER/16/052012
01/06/2012
31/05/2013
7000
PER/17/052012
01/06/2012
31/05/2013
7000
00141
KLINIK LHOKSEUMAWE
0645-48501
24352
JAMALUDDIN
04482
KRUENG GEUKEH
-085277907770 24352
H. IRSYAD H. ABDULLAH
05610
PPK - I TAKENGON
24552
DR. H. ALIYIN
03881
PPK I BIREUN
24354
DR. AKMAL
05096
PPK I- LHOKSUKON
24352
JAMALUDDIN
04893
24352
HJ HASMI HASAN
06431
24352
PER/42/112012
01/09/2012
31/08/2013
07367
24352
PER/12/052012
01/06/2012
31/05/2013
06430
24352
PER/31/092012
01/09/2012
31/08/2013
3000
10
07662
-085261930888 24352
PER/35/112012
01/11/2012
31/10/2013
3000
11
06429
24352
DR.INDRA Z.,SP.THT-KL
PER/23/072012
01/08/2012
31/07/2013
3000
12
06354
0645-631035
24352
PER/37/112012
01/08/2012
31/07/2013
3000
13
06432
-081375950820 24352
PER/36/112012
01/10/2012
30/09/2013
3000
14
06209
0645-43012
24352
0645-43012
PER/19/052012
01/06/2012
31/05/2013
7000
15
07659
0644-323055
24261
0644-323155
PER/38/112012
01/11/2012
31/10/2013
3000
16
04483
RSU BUNDA
JL DARUSSALAM NO 16 LHOKSEUMAWE
0645-46924
24352
0-
PER/13/052012
01/05/2012
30/04/2013
7000
17
03984
0645-44821
24352
0645-48600
PER/14/052012
01/06/2012
31/05/2013
7000
18
06894
24352
0645-653189
PER/40/112012
01/11/2012
31/10/2013
7000
19
07660
APOTEK BMC
0644-323055
24261
PER/39/112012
01/12/2012
30/11/2013
3000
20
06547
24352
DJAMALUDDIN
PER/04/012012
01/01/2012
31/12/2012
7000
21
03985
APOTIK KHANA
0645-46624
24352
PANJI KESUMA
PER/03/012012
01/01/2012
31/12/2012
7000
22
07661
OPTIK MANDIRI
0645-43657
24352
AGUS HADYANTO
PER/44/112012
01/12/2012
30/11/2013
3000
23
07368
OPTIK NURUL
24352
NURUL A'LA
PER/30/082012
01/06/2012
31/05/2013
24
03986
OPTIK TIARA
0645-43481
24352
IR. ZULFAKAR
PER/02/012012
01/01/2012
31/12/2012
25
07779
24352
HO WEI MIN
PER/05/022012
01/02/2012
31/03/2013
26
04734
TIAS OPTIK
-085278247824 24352
MIRAWATI
PER/43/112012
01/11/2012
31/10/2013
RI244010
70
3000
7000
7000
PKR102001
Halaman :
Tanggal :
10/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
00142
0651-33345
23351
0651-31105
HJ KARTINI NI
04768
24115
07347
HB SENTRA MEDIKA
0651-7122163 23351
06876
KLINIK AISHA
0651-7455657 23351
ANDI ASNADI
06877
KLINIK AISHA-07
0651-7471123 23351
07397
0812-18334941 23517
07797
0651-7551235 23353
07006
0651-7124174 23351
BAKHTIAR SH
07842
KLINIK MINA
-08126902670 23351
DR RAHMI
10
03791
0651-31105
23351
HJ KARTINI N I
11
06937
RS HARAPAN BUNDA
0651-48114
23351
0651-40856
12
07154
RS U'BUDIYAH
0651-7555750 23362
13
06626
0651-638701
14
03790
15
07123
16
07122
17
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/01/012013
01/01/2013
31/12/2013
PER/06/012012
01/01/2012
31/12/2012
01/06/2012
31/05/2013
PER/13/112012
01/11/2012
31/12/2013
5000
DR ANDRI ASNADI
PER/14/112012
01/11/2012
31/12/2012
5000
DRG ZULEIKA
PER/24/062012
01/07/2012
30/06/2013
7000
PER/25/032012
01/04/2012
31/03/2013
7000
PER/17/012012
01/01/2012
31/12/2012
5000
PER/26/032012
01/04/2012
31/03/2013
PER/002/012012
01/01/2012
31/12/2012
7000
PER/15/112012
01/11/2012
31/12/2013
1000
PER/21/032012
01/03/2012
28/02/2013
7000
23351
0651-638692
HERI RISWANDI
PER/12/062012
01/06/2012
31/05/2013
0651-41454
23351
0651-42754
DR H M SALEH SURATNO
PER/004/012012
01/01/2012
31/12/2012
7000
0651-45441
23363
ABUBAKAR SMHK
PER/18/022012
01/02/2012
31/01/2013
7000
0651-24364
23354
0651-24364
ABUBAKAR SMHK
PER/19/022012
01/02/2012
31/01/2013
7000
05433
APOTEK FAKINAH
23351
DR H M SALEH SURATNO
PER/05/012012
01/01/2012
31/12/2012
7000
18
03792
-065131105
23351
DRA SYAMSULIANI
PER/03/012012
01/01/2012
31/12/2012
7000
19
94769
APOTIK PIDIE
JL PERDAGANGAN NO 11 SIGLI
23351
H RUSDI H AHMAD
20
04769
JL PERDAGANGAN NO 11 SIGLI
24151
H. RUSLI
PER/07/012012
01/01/2012
31/12/2012
7000
21
05949
23351
HERI RISWANDI
PER/11/012012
01/01/2012
31/12/2012
7000
22
07124
NANGGROE OPTICAL
0651-34086
23361
AINUL MARDHIAH
PER/20/022012
01/02/2012
31/01/2013
5000
23
05434
LABORATORIUM MINA
0651-31105
23351
0651-31105
DR HARWITA SP.PK
PER/08/012012
01/01/2012
31/12/2012
7000
RI244010
v
v
v
v
7000
7000
7000
7000
PKR102001
Halaman :
Tanggal :
11/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
06039
PUSKESMAS BENDAHARA
-085277213585 24473
04220
PUSKESMAS JULOK
24452
00147
24475
04531
06731
PUSKESMAS RANTAU
06270
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/07/052012
01/02/2012
30/01/2013
5000
DR FAUZAN
PER/13/072012
01/07/2012
30/06/2013
1000
DR H M NUR FAJRI
PER/21/082012
01/09/2012
31/08/2013
1000
-08126453596 24475
PER/33/122012
01/01/2013
30/06/2013
2000
-085260434525 24476
PER/08/062012
01/06/2012
31/05/2013
5000
24454
MURHABAN, SKM
PER/12/072012
01/08/2012
31/07/2013
5000
06271
24415
PER/10/062012
01/08/2012
31/07/2013
5000
07450
24454
DR ZULFIKRY
PER/18/082012
01/08/2012
31/07/2013
5000
00155
0641-23032
24415
DR SYAFRIRUDDIN
PER/04/022012
01/02/2012
31/01/2013
10000
10
03627
0641-23071
24415
LIDYA SIREGAR, SE
PER/20/082012
01/08/2012
30/09/2012
5000
11
06269
RSU IDI
24454
PER/30/112012
01/11/2012
31/10/2013
5000
12
06730
0641-332983
24476
0641-332983
PER/25/102012
01/10/2012
30/09/2013
5000
13
06290
0641-21039
24415
PER/19/082012
01/08/2012
31/07/2013
1000
14
05428
JL T M ZEIN NO 1E
0641-21020
24415
0641-424809
PER/34/122012
01/01/2013
31/12/2013
7000
15
07448
0641-332983
24476
0641-332983
DR ZUHEINI, M.KES
PER/24/102012
01/10/2012
30/09/2013
1000
16
06733
OPTIK LANGSA
24415
KIT FIN
PER/09/062012
01/06/2012
31/05/2013
1000
RI244010
v
v
v
v
v
v
PKR102001
Halaman :
Tanggal :
12/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
06408
DR ARFANDI BUKIT
23615
DR ARFANDI BUKIT
04733
DR EMMALIANA SUANDY
-08126936426 23652
DR EMMALIANA SUANDY
07710
DR IBRAHIM NASUTION
06409
DR MARDIANA MANIK
23752
07905
DR RUDI KURNIAWAN
06944
DR SYAFRIZAL
06456
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/22/122011
01/12/2011
30/11/2012
PER/16/062012
01/07/2012
30/06/2013
DR IBRAHIM NASUTION
PER/03/012012
01/01/2012
31/12/2012
5000
DR MARDIANA
PER/24/122011
01/12/2011
30/11/2012
7000
0852-96625546 23752
DR RUDI KURNIAWAN
PER/24/102012
01/10/2012
31/12/2012
7000
23763
DR SYAFRIZAL
PER/18/102011
01/10/2011
30/09/2012
3500
24651
PER/08/022012
01/02/2012
31/01/2013
7000
08123
0852-60629133 23711
PER/25/112012
01/12/2012
31/12/2013
5000
08140
0821-61141360 23653
PER/29/122012
01/12/2012
31/12/2013
5000
10
06844
0813-60134571 23652
PER/19/092012
01/09/2012
31/08/2013
7500
11
06948
0812-6626693 23752
PER/19/112011
01/11/2011
31/10/2012
3500
12
07582
DRG WARDIATI
23752
DRG WARDIATI
PER/18/082012
01/09/2012
31/08/2013
5000
13
08139
0821-65914447 23653
PER/30/122012
01/12/2012
31/12/2013
5000
14
08125
JL. ISKANDAR MUDA NO. 15 RIMO (APOTEK INDAH SARI) KAB. 0852-39992272 24783
ACEH SINGKIL
PER/22/112012
01/11/2012
31/12/2013
5000
15
06457
DRG. ZAINUDDIN
23752
DRG. ZAINUDDIN
PER/09/022012
01/02/2012
31/01/2013
7000
16
07055
0813-60097163 23652
DERI DARMAWAN
PER/01/012013
01/01/2013
31/12/2013
17
06896
23763
PER/17/082012
01/09/2012
31/12/2013
10000
18
03814
0655-21137
23652
PER/20/112011
01/11/2011
31/10/2012
7000
19
06410
23752
PER/26/122011
01/12/2011
30/11/2012
7000
20
06947
23615
PER/21/112011
01/12/2011
30/11/2012
21
06420
APOTEK BERKAH
23752
PER/25/122011
01/12/2011
30/11/2012
7000
22
06643
APOTEK IKHWANA
23782
H SALMUDIN
PER/10/022012
01/02/2012
31/01/2013
7000
23
06897
APOTEK LARIS 3
23763
AZHAR SE AK
PER/15/062012
01/07/2012
30/06/2013
10000
24
06411
23752
ELFIANA
PER/23/102012
01/10/2012
31/12/2013
7000
25
06902
23652
MUSTHAFA
PER/20/092012
01/09/2012
31/08/2013
10000
26
05969
OPTIK INTERNASIONAL
23652
PER/004/122008
01/12/2008
30/11/2009
5000
RI244010
3500
3500
PKR102001
Halaman :
Tanggal :
13/239
15-01-2013
16:22:40
PEMILIK
NO
NO. PPK
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
27
08124
RI244010
REFARMASI OPTICAL
0852-77199994 23711
HENDRI MAKHLIZAR
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
PER/01/012012
JUMLAH
TTG
31/12/2012
PKR102001
Halaman :
Tanggal :
14/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/23/122012
01/01/2013
30/06/2013
13000
PER/22/122012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
KAMIS, JUM'AT,
GIGI (SHIFT 1), SALIN (SHIFT
SABTU, MINGG
1)
01/01/2013
30/06/2013
7000
PER/24/122012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
KAMIS, JUM'AT,
GIGI (SHIFT 1), SALIN (SHIFT
SABTU, MINGG
1)
01/01/2013
30/06/2013
7000
PER/25/122012
01/01/2013
30/06/2013
10000
DR SOFIAN WIJAYA
PER/34/122012
01/01/2013
30/06/2013
7000
SRI REZEKI SE
PER/16/122012
01/01/2013
30/06/2013
16500
20352
PER/33/122012
01/01/2013
30/06/2013
5000
061-4158341
20352
SUHARDI
PER/17/122012
01/01/2013
30/06/2013
7000
20586
DRS.H.ISMAIL EFFENDY,M.SI
PER/28/122012
01/01/2013
30/06/2013
7000
JL UDARA NO 2A
0628-91002
22153
PER/27/122012
SENIN, SELASA, RABU, UMUM (SHIFT I,SHIFT II),
GIGI (SHIFT I), SALIN (SHIFT
KAMIS, JUM'AT,
I)
SABTU, MINGG
01/01/2013
30/06/2013
7000
03078
081-396697999 20352
DR SAYID BUDHI
PER/20/122012
01/01/2013
30/06/2013
7000
12
03302
JL DARUSALAM NO 10
061-4153169
20352
061-4143903
DR SAYID BUDHI
PER/19/122012
01/01/2013
30/06/2013
7000
13
06018
KLINIK AKSARA
20372
DRS.H.ISMAIL EFFENDY,M.SI
PER/29/122012
01/01/2013
30/06/2013
8000
14
07600
20352
DR YUDHA PRAYOGI
PER/31/122012
01/01/2013
30/06/2013
5000
15
04780
061-77013755 20123
M KAMAL SALEH
PER/30/122012
01/01/2013
30/06/2013
7000
16
03039
KLINIK KURNIA
061-8454200
20127
061-7368045
TAN ERFI
PER/18/122012
01/01/2013
30/06/2013
7000
17
07265
20352
DR H DEPI MASRI
PER/32/122012
01/01/2013
30/06/2013
3500
18
05349
061-7789007
20352
NETTY BARITA
PER/26/122012
01/01/2013
30/06/2013
10500
19
03298
JL GATSU NO
061-4146404
20352
061-4155528
PER/21/122012
01/01/2013
30/06/2013
7000
20
07267
RS EFARINA ETAHAM
0628-323716
22153
0628-323718
PARHIMPUNAN SIMATUPANG
PER/42/122011
01/01/2012
31/12/2012
21
05525
061-8475111
20352
061-8445270
DR ANTONIUS GINTING SE
PER/41/122012
01/01/2012
31/12/2012
22
03697
RSU ESTOMIHI
061-7861771
20218
061-7866660
DR.DONNA SIANTURI
PER/39/122011
01/01/2012
31/12/2012
7000
23
03698
RSU HELVETIA
061-8465779
20361
061-8451021
HJ.RAZIA SUROYO
PER/37/122011
01/01/2012
31/12/2012
7000
24
03102
RSU MELATI
061-4560039
20371
061-4560039
SUHARDI
PER/20/012010
01/01/2010
31/12/2010
7000
25
07074
061-7875967
20352
061-7850261
DR PARAMBIR SINGH
PER/40/122011
01/01/2012
31/12/2012
03033
BP AVIATY MEDAN
061-8283278
20352
061-8213187
AMETA P RIZAL
03703
BP AZIZI
JL KAPTEN SUMARSONO NO 74
-061-8471111 20352
061-4155528
04002
BP HARAPAN BUNDA
061-77804129 20153
061-4515129
NETTY BARITA SE
04576
BP HARAPAN BUNDA II
061-7852634
20159
NETTY BARITA, SE
04580
061-4535222
20153
061-4535104
05957
BP MILLENIUM
061-8451468
20352
07899
061-8215305
05526
BP RIZKY
06015
BP SUMARSONO
10
06578
11
RI244010
PKR102001
Halaman :
Tanggal :
15/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
26
03303
JL KAPT MUSLIM NO 79
061-8451812
27
04210
JL SURAKARTA NO 2 MEDAN
7000
28
03304
JL TIMOR NO 27 D
7000
29
03309
APOTIK ANUGERAH
JL GATOT SUBROTO NO 96 B
061-4527207
20123
HELEN
PER/32/012009
01/01/2009
31/12/2009
7000
30
04574
JL ASIA NO 70 MEDAN
061-7365870
20153
PER/33/122011
01/01/2012
31/12/2012
7000
31
03308
061-4527207
20153
PER/32/122011
01/01/2012
31/12/2012
7000
32
06494
APOTIK PRATAMA
061-4154806
20352
PER/44/012012
01/01/2012
31/12/2012
33
03306
APOTIK RAYA
JL JUANDA BARU
061-7342045
20153
DESMAWATI
PER/18/122011
01/01/2012
31/12/2012
7000
34
04093
061-8451812
20352
DRS W PURBA
PER/30/122011
01/01/2012
31/12/2012
7000
35
06579
061-8455003
20352
LIE HOLO
PER/31/122011
01/01/2012
31/12/2012
36
04211
APOTIK TERATAI
061-7876889
20352
HEPATA K L S MUTE
PER/19/122011
01/01/2012
31/12/2012
37
03307
JL HM YAMIN NO 69/147
38
05958
OPTIK INDONUSA
061-4150095
20361
RIFAI TASLIM
PER/12/122011
01/01/2012
31/12/2012
39
06371
OPTIK KOLMAD
061-4150995
20371
PER/34/122011
01/01/2012
31/12/2012
40
03312
061-4556164
20352
PER/35/012009
01/01/2009
31/12/2009
7000
41
03314
061-4555093
20352
PER/35/012009
01/01/2009
31/12/2009
7000
42
04217
20352
PER/35/012008
01/01/2008
31/12/2008
7000
43
04215
061-4140228
20352
PER/35/012009
01/01/2009
31/12/2009
7000
44
03310
061-4523148
20352
PER/35/012009
01/01/2009
31/12/2009
7000
45
03313
061-4526651
20352
DINA ELDELINA
PER/35/122011
01/01/2012
31/12/2012
7000
46
03316
061-8225358
20153
PER/35/012009
01/01/2009
31/12/2009
7000
47
04214
061-4501028
20153
DINA ELDELINA
PER/35/012009
01/01/2009
31/12/2009
7000
48
03311
061-4576181
20352
PER/35/012008
01/01/2008
31/12/2008
7000
49
04573
OPTIK TRIJAYA
061-7330045
20352
ANDAM SARI,SE
PER/38/122011
01/01/2012
31/12/2012
7000
50
03315
JL GATOT SUBROTO NO 18 C
7000
51
04216
7000
52
03317
7000
53
04213
061-4524236
20114
GUNAWAN WIBOWO
PER/14/122011
01/01/2012
31/12/2012
7000
54
04212
061-4530739
20212
061-4535740
DR HELY
PER/25/122011
01/01/2012
31/12/2012
7000
RI244010
20123
061-8452134
DR.DELI THEO
PER/36/122011
01/01/2012
31/12/2012
7000
7000
7000
PKR102001
Halaman :
Tanggal :
16/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/22/072012
01/07/2012
30/06/2013
5000
PER/04/012013
01/01/2013
31/12/2013
7000
01/11/2011
31/10/2012
8000
PER/24/102012
01/11/2012
31/10/2013
7000
PER/19/052012
01/05/2012
30/04/2013
7000
PER/20/072012
01/07/2012
30/06/2013
PER/02/012013
01/01/2013
31/12/2013
PER/29/112012
01/11/2012
31/10/2013
PER/23/032012
01/03/2012
28/02/2013
7000
PER/26/042012
SENIN, SELASA, RABU, UMUM (SHIFT
MALAM,SHIFT SIANG,SHIFT
KAMIS, JUM'AT,
PAGI), GIGI (SHIFT SORE)
SABTU, MINGG
01/04/2012
31/03/2013
7000
DR AMRAN H SITUMORANG
PER/01/012013
01/01/2013
31/12/2013
7000
SET ARTATI
PER/13/042012
01/05/2012
30/04/2013
3000
21187
DR. KURNIAWAN
PER/03/012013
01/01/2013
31/12/2013
10000
JL SANGNAWALUH NO 36 P SIANTAR
0622-7550123 21187
PER/05/012013
01/01/2013
31/12/2013
7000
0813-76662333 21168
PER/25/042012
01/04/2012
31/03/2013
7000
06688
0632-331234
22381
PER/17/062012
01/07/2012
30/06/2013
7000
17
06623
22452
TONNY LUMBANTOBING
PER/21/072012
01/08/2012
31/07/2013
3000
18
03229
RS TENTARA
0622-21071
21187
PER/08/012012
01/01/2012
31/12/2012
7000
19
06625
0633-21303
22452
0633-20450
PEMDA TARUTUNG
PER/15/062012
01/06/2012
31/05/2013
3000
20
07896
0622-23823
21187
0622-23824
PEMERINTAH KOTA
PEMATANGSIANTAR
PER/03/052012
01/06/2012
31/05/2013
7000
21
05315
22391
22
08092
0622-433666
21111
0622-21384
23
06562
0623-21843
22376
0623-322636
24
06563
22376
25
05458
APOTIK SIMALUNGUN
JL SUTOMO NO17
21151
YASIN PUTRA
26
05049
OPTIK LAMA
0622-24309
21187
SUHARDI, RO
07398
0813-76015825 21163
00164
PUSKESMAS PERDAGANGAN
0813-70676568 21162
PUSKESMAS PERDAGANGAN
06928
PUSKESMAS SERBELAWAN
0813-70458808 21184
PUSKESMAS SERBELAWAN
08033
PUSKESMAS SILANGIT
22452
PUSKESMAS SILANGIT
07171
0813-61216170 21151
07382
22376
FLORIDA SILALAHI
04421
BP MARISTELLA
JL DI PANJAITAN NO 45 PORSEA
22376
08102
BPS NARWASTU
21167
07751
KLINIK KARO-KARO
22153
10
07802
KLINIK PANDU
0622-96309
21165
ANTONIUS
11
00159
KLINIK PUTRI
-062541445
21156
12
06622
KLINIK PUTRI
0813-76137512 21154
13
00166
KLINIK SERASI
-062228756
14
04492
15
07801
16
RI244010
5000
7000
v
v
5000
PER/06/012009
01/01/2009
31/12/2009
5000
PER/ 28/102012
01/11/2012
30/10/2013
7000
PER/10/032012
01/03/2012
28/02/2013
7000
PER/11/032012
01/03/2012
28/02/2013
7000
PER/06/012013
01/01/2013
31/12/2013
7000
PER/07/012013
01/01/2013
31/12/2013
70
PKR102001
Halaman :
Tanggal :
17/239
15-01-2013
16:22:40
PEMILIK
NO
NO. PPK
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
27
05509
RI244010
0622-24342
21187
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
PER/09/012012
JUMLAH
TTG
31/12/2012
PKR102001
Halaman :
Tanggal :
18/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
04871
21251
08147
0852-97799888 21416
03252
-623355124
21251
DRG ZANIYAR
04770
BPS "SEHAT"
21452
DR MARLINAWATI
07938
BPS SAUDARA
0813-76220322 21457
DR EKA SUSILAWATI
08026
KLINIK AULIA
0622-632088
21257
0622-632088
03253
KLINIK ESTOMIHI
-0623597040
21251
DR PATAR MT PANJAITAN
07895
KLINIK HARUN
JL. ACCESS ROAD INALUM DUSUN PENGAJIAN DESA LALANG KEC. MEDANG DERAS
21258
07439
0623-596921
21351
10
06380
KLINIK RAKYAT
0624-351246
11
06031
KLINIK SARTIKA
0624-551050
12
06965
13
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/01/012013
01/01/2013
31/12/2013
15000
15000
PER/78/122012
01/01/2013
31/12/2013
PER/02/012013
01/01/2013
31/12/2013
15000
PER/03/012013
01/01/2013
31/12/2013
7000
PER/47/062012
01/07/2012
30/06/2013
PER/59/082012
01/09/2012
31/08/2013
7000
PER/04/012013
01/01/2013
31/12/2013
15000
PER/42/052012
01/05/2012
30/04/2013
7000
H. HUSIN
PER/05/012013
01/01/2013
31/12/2013
15000
21412
PER/06/012013
01/01/2013
31/12/2013
15000
21463
PER/07/012013
01/01/2013
31/12/2013
15000
H KURNAN SITUMORANG
PER/08/012013
01/01/2013
31/12/2013
15000
07698
21258
PER/09/012013
01/01/2013
31/12/2013
7000
14
07644
JL. BEDAGAI NO. 129 KOTA PINANG KAB LAB BATU SELATAN -
21463
PER/10/012013
01/01/2013
31/12/2013
15000
15
08132
PRAKTEK DR KWASAI
JL. TENGKU UMAR NO. 55-D LK III KEL KARYA KEC TANJUNG 0623-93496
BALAI SELATAN
21311
DR KWASAI
PER/76/122012
01/01/2013
31/12/2013
16
07645
JL DIPONEGORO KISARAN
21251
DR PATAR MT PANJAITAN
PER/11/012013
01/01/2013
31/12/2013
7000
17
06109
21457
DR SAIFUL MARI
PER/12/012013
01/01/2013
31/12/2013
7000
18
07924
21457
19
06840
AEK NABARA
0624-520269
21452
0624-29250
20
07446
0623-3452238 21272
0623-345238
21
03835
-062341785
21251
22
06545
0624-21228
21452
23
07625
RS SETIO HUSODO
0623-44999
21254
MARDI
24
07086
APOTEK JAKARTA
0624-21811
21455
HERAWATY
25
07300
APOTIK MANDIRI
21251
MARDI
7000
7000
PER/45/062012
01/07/2012
30/06/2013
15000
PER/43/092011
01/09/2011
31/12/2012
7000
PER/66/082012
01/08/2012
31/07/2013
PER/63/122011
01/01/2012
31/12/2012
7000
PER/66/122011
01/01/2012
31/12/2012
7000
PER/56/122011
14/12/2011
31/12/2012
7000
PER/64/122011
01/01/2012
31/12/2012
7000
IKS/28/042011
01/05/2011
30/04/2012
RI244010
PKR102001
Halaman :
Tanggal :
19/239
15-01-2013
16:22:40
PEMILIK
NO
NO. PPK
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
26
03712
27
07299
JL. COKROAMINOTO NO. 314 KEL. KISARAN BARU KEC. KOTA 08216-7250338 21261
KISARAN BARAT
28
03259
KISARAN OPTIKAL
JL SUTOMO 36 KISARAN
-062341250
29
03713
MATAHARI OPTIKAL
30
07510
RI244010
RS
APT
EDHIE KOSASIH
AMIRUDDIN PANGARIBUAN
21251
ANTON HO
0623-41737
21251
0624-21183
21412
0623-41627
21251
SYAHRIAL BATARA
HARI BUKA
PPK II
OPT LAB PEM ABRI BUMN SWASTA
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/13/012011
01/01/2011
31/12/2011
IKS/29/042011
01/05/2011
30/04/2012
PER/72/122011
01/01/2012
31/12/2012
7000
PER/68/122011
01/01/2012
31/12/2012
7000
PER/42/092011
01/09/2011
31/12/2012
7000
PKR102001
Halaman :
Tanggal :
20/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/01/012013
01/01/2013
31/12/2013
7000
PER/04/012013
01/01/2013
31/12/2013
7000
PER/05/012013
01/01/2013
31/12/2013
7000
PER/02/012013
01/01/2013
31/12/2013
7000
PER/01/092012
01/09/2012
31/08/2013
7000
PER/01/032012
01/03/2012
28/02/2013
PER/06/012013
01/01/2013
31/12/2013
7000
PER/03/012013
01/01/2013
31/12/2013
7000
-081298240986 22562
PER/09/012013
01/01/2013
31/12/2013
7000
0816-3125402 22731
DRG KHOIRUNNISA
PER/01/102012
01/10/2012
31/12/2012
7000
-085275037654 22562
DRG. BURHANUDDIN
PANGGABEAN
PER/02/092012
01/09/2012
31/08/2013
7000
07861
KLINIK RIZKY
-081397752275 22731
PER/01/052012
01/05/2012
30/04/2013
7000
13
06940
22731
DR ADE KURNIAWATHY
PER/02/112012
01/11/2012
30/06/2013
7000
14
06978
-08126357411 22731
DR MEINI BASYARIAH
PER/08/012013
01/01/2013
31/12/2013
7000
15
07460
22852
PER/03/082011
01/08/2011
31/07/2012
7000
16
07156
22731
PER/01/032012
01/03/2012
28/02/2013
7000
17
03746
JL DR FL TOBING
22562
PER/05/012012
01/01/2012
31/12/2012
7000
18
07217
-08126455987 22731
PER/03/042012
01/04/2012
31/03/2013
7000
19
06764
0636-20279
22989
0636-20712
DR SYAFII SIREGAR SP OG
PER/07/012012
01/01/2012
31/12/2012
7000
20
07769
0636-421891
22731
0636-421311
PER/01/032012
01/03/2012
28/02/2013
21
07216
APOTEK KPN
-081263064766 22731
PER/04/042012
01/04/2012
31/03/2013
22
05850
APOTEK SEGAR
0631-21519
22562
PER/04/092012
01/09/2012
31/12/2012
23
08110
APOTIK KASIH
0631-24857
22511
NOVITA
PER/01/112012
01/11/2012
31/12/2012
24
03747
APOTIK PANGGABEAN
JL A YANI 13
0631-22620
22562
MANUNGGANG PANGGABEAN
PER/06/012012
01/01/2012
31/12/2012
25
07804
APOTIK RAHMAT
-085261112507 22731
SYAFRUDDIN HARAHAP
PER/01/042012
02/04/2012
31/03/2013
26
06543
OPTIK LAI
0631-22965
LAIMAN BAHARI
PER/03/012012
01/01/2012
31/12/2012
04645
-0631-21356
22562
06542
PUSKESMAS PORTIBI
-081397805360 22731
06460
-081397997190 22731
05918
PUSTU TABUYUNG
-081533330865 22731
04299
DR SRI WAHYUNI
-063423788
22753
06041
DR YUDIKA KRISTIANA
22852
DR YUDIKA KRISTIANA
ZENDRATO
07550
-081361652465 22731
08148
-081370391704 22733
08044
10
05183
DRG KHOIRUNNISA
11
08052
12
22562
7000
7000
7000
7000
RI244010
PKR102001
Halaman :
Tanggal :
21/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
27
04406
RI244010
REGAR OPTICAL
22731
RACHMAT SIREGAR
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
PER/05/092012
JUMLAH
TTG
31/12/2012
7000
PKR102001
Halaman :
Tanggal :
22/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/32/122012
01/01/2013
30/06/2013
9999
PER/21/122012
01/01/2013
30/06/2013
7000
PER/22/122012
01/01/2013
30/06/2013
7000
PER/18/122012
01/01/2013
30/06/2013
8000
PER/09/122012
01/01/2013
30/06/2013
7000
PER/11/122012
01/01/2013
30/06/2013
7000
DRG. ZAHNIYAR
PER/31/122012
01/01/2013
30/06/2013
7000
KURNIAWAN DR
PER/17/122012
01/01/2013
30/06/2013
7000
20551
HILMAN SITUMEANG
PER/26/122012
01/01/2013
30/06/2013
11000
20587
PER/27/122012
01/01/2013
30/06/2013
7000
061-7957027
20551
NGADRI
PER/28/122012
01/01/2013
30/06/2013
7000
-0617388028
20552
DR. ERIZAL
PER/24/122012
01/01/2013
30/06/2013
7000
03556
BP/KLINIK RAIHAN
061-7874760
20228
PER/23/122012
01/01/2013
30/06/2013
14000
14
03778
061-7945689
20551
DR.M. ARSHAD
PER/16/122012
01/01/2013
30/06/2013
7000
15
03631
BPS AS SYIFA
061-7946460
20551
PER/08/122012
01/01/2013
30/06/2013
7000
16
06755
0852-75256402 20551
ENDAH WAHYUNI
PER/29/122012
01/01/2013
30/06/2013
7000
17
07995
0621-441543
20587
PER/33/122012
01/01/2013
30/06/2013
7000
18
03011
061-7866930
20551
PER/10/122012
01/01/2013
30/06/2013
14000
19
04550
061-7864556
20551
DR. M. ARSHAD
PER/15/122012
01/01/2013
30/06/2013
7000
20
03354
KLINIK MORAWA II
JL TJ MORAWA KM 17
061-7942361
20551
TAN ERFI
PER/20/122012
01/01/2013
30/06/2013
14000
21
05653
KLINIK PUJA
0812-63792808 20551
PER/30/122012
01/01/2013
30/06/2013
7000
22
03020
-7943976
20551
PER/12/122012
01/01/2013
30/06/2013
17000
23
07275
RB HAMIDAH II
0813-96641626 20552
PER/13/122012
01/01/2013
30/06/2013
6666
24
03352
RB MITRA SEHAT
-08126020191 20551
PER/19/122012
01/01/2013
30/06/2013
8000
07427
0812-6362730 20551
03351
JL KABUPATEN NO 5 PERBAUNGAN
081-53101466 20000
06216
20582
05652
BP / RB MANNA
061-7879542
20551
04611
BP DJOHAN
20000
03777
20551
06114
BP KESUMA BANGSA
081-397689667 20551
03348
BP KURNIA SEHAT
0621-859770
20651
05971
BP PAKAM
061-7953061
10
06172
BP PATUMBAK
11
06364
BP PELITA BUNDA
12
03350
13
RI244010
M SYARIFUDDIN
Halaman :
Tanggal :
23/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
25
04682
RB SULASTRI
0621-21406
20651
26
07868
RB TUTUN SEHATI
061-7945676
20551
27
06234
28
04549
29
03355
JL THAMRIN
30
06423
31
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
KAMIS, JUM'AT,
SABTU
UMUM (SHIFT 1)
PER/25/122012
01/01/2013
30/06/2013
7000
PER/34/122012
01/01/2013
30/06/2013
7000
PER/14/122012
01/01/2013
30/06/2013
9000
PER/140/122011
01/01/2012
31/12/2012
DR IRVAN DALIMUNTHE
SALMIAH ZAKARIA
20587
M. SYARIFUDDIN
-0617940184
20551
PTPN II
20581
0621-442100
20551
0621-442022
06365
061-7955114
20551
32
03360
RS HERNA
JL BALAI KOTA
20651
33
03359
34
07656
35
07865
36
7000
PER/137/122011
01/01/2012
31/12/2012
DR H. SYAHRIAL SIREGAR,MARS
PER/109/062011
01/07/2011
31/12/2011
DRS. JOHANNES S
PER/142/122011
01/01/2012
31/12/2012
PER/139/122011
01/01/2012
31/12/2012
7000
20583
PER/138/122011
01/01/2012
31/12/2012
7000
061-7990056
20551
DR TONDY
PER/07/062012
01/07/2012
31/12/2012
20551
061-7950313
NATANIEL P NAINGGOLAN SH
PER/02/042012
01/05/2012
31/12/2012
07358
061-7944555
20551
061-7944555
HJ HERAWATI SH
PER/144/122011
01/01/2012
31/12/2012
37
05972
061-7030802
20551
061-7030083
PER/141/122011
01/01/2012
31/12/2012
38
07657
JL BESAR NO 77 DELITUA
061-7030802
20551
061-7030083
PER/155/122011
01/01/2012
31/12/2012
39
03363
APOTIK BINTANG
HAN PHO
PER/147/122011
01/01/2012
31/12/2012
7000
40
06115
APOTIK DELI
061-7031460
20551
DAPOTAN SINURAT
PER/98/062011
01/07/2011
31/12/2011
7000
41
03361
20551
JESSICA WIRYA
PER/148/122011
01/01/2012
31/12/2012
7000
42
03362
20651
PER/149/122011
01/01/2012
31/12/2012
7000
43
07426
061-7955114
20551
061-7954914
PER/151/122011
01/01/2012
31/12/2012
44
03365
OPTIK 99
20551
01/01/2009
31/12/2009
7000
45
03366
OPTIK ASEAN
20551
PER/152/122011
01/01/2012
31/12/2012
7000
46
07276
OPTIK OSCAR
061-77077999 20551
PER/154/122011
01/01/2012
31/12/2012
47
03630
OPTIK TREND
20551
01/01/2008
31/12/2008
48
06517
061-7951442
20551
PER/153/122011
01/01/2012
31/12/2012
49
03367
OPTIK QUEEN
JL IRIAN
50
07274
061-7951008
RI244010
GO SIKANG
20551
7000
7000
v
GUNAWAN WIBOWO
7000
PER/146/122011
01/10/2011
31/12/2012
PKR102001
Halaman :
Tanggal :
24/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
90277
ANGELIR
0751-63162
25391
DR FERI MULYANI
03323
BP BINA SEJAHTERA
JL SIMPANG KANTOR NO 6
061-6851396
20352
PER/32/122012
01/01/2013
30/06/2013
14010
00261
BP HAJI BILAL
20352
TAKBIR SIREGAR
PER/36/122012
01/01/2013
30/06/2013
7000
06138
BP HAJI MEDAN-MABAR
061-6856045
20352
PER/37/122012
01/01/2013
30/06/2013
14000
04000
BP HAJI PANCING
-06177861729 20352
DR H HASNAWATI
PER/41/122012
01/01/2013
30/06/2013
14055
00258
BP HELVETIA VIII
061-6940382
20352
IR ABIDAH
PER/35/122012
01/01/2013
31/03/2013
7000
00204
061-6852760
20352
NURHAYATI
PER/39/122012
01/01/2013
31/03/2013
7000
08051
BP QITA MEDIKA
20112
ANDY CHEN
PER/46/122012
01/01/2013
30/06/2013
7000
03755
KLINIK CITRA
-0614142488
20352
DRG SUMIATI
PER/43/122012
01/01/2013
30/06/2013
7000
10
03756
061-6858393
20352
PER/44/122012
01/01/2013
30/06/2013
14000
11
03324
KLINIK DELIMA
061-6940598
20352
HJ NURDELIMA SIHOMBING
PER/33/122012
01/01/2013
30/06/2013
7000
12
04457
061-6612251
20352
TAKBIR SIREGAR
PER/40/122012
01/01/2013
30/06/2013
7000
13
00270
20352
IR ABIDAH
PER/34/122012
01/01/2013
31/03/2013
7000
14
03319
KLINIK HJ TJ MULIA
JL K. SUDARSO KM 7 NO 12
061-77832084 20352
TAKBIR SIREGAR
PER/38/122012
01/01/2013
30/06/2013
7000
15
03329
KLINIK RIKA
JL STASIUN BELAWAN
20352
DR KAHERMA SARI
PER-AD/14/012008
01/02/2008
31/12/2008
7000
16
07931
20352
HALIL SE
PER/45/122012
01/01/2013
30/06/2013
7000
17
03500
-0811632573
20352
DR KURNIAWAN
PER/42/122012
01/01/2013
31/03/2013
7000
18
04436
19
03330
KLINIK REZA
JL BILAL 137 B
217163
01/01/2004
31/12/2005
7000
20
03321
JL KARYA NO 54 A/46
217154
01/01/2000
31/12/2005
7000
21
03335
RUMKITDAM BB II
JL PUTRI HIJAU NO 17
20352
PER/18/012012
01/01/2012
31/12/2012
7000
22
03338
JL UJUNG BARU
20352
PER/17/012012
01/01/2012
31/12/2012
7000
23
06512
RS AMETA SEJAHTERA
061-6851396
20352
AGENDA ERLIANA G
PER / 19 / 012012
01/01/2012
31/12/2012
7000
24
03824
-0616631380
20361
PER/15/012012
01/01/2012
31/12/2012
7000
25
04723
RS MARTHA FRISKA
20352
PER/29/012012
01/01/2012
31/12/2012
700
26
03757
-0616642238
20352
PER/14/012012
01/01/2012
31/12/2012
7000
RI244010
7000
v
v
PKR102001
Halaman :
Tanggal :
25/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
27
05999
061-8463432
20373
28
06000
061-8441111
20354
DR H. YOURMANSYAH
29
03336
061-6619520
20352
061-6619519
30
03337
JL MEDAN MARELAN
061-6850445
20352
31
03344
JL PANCING NO 13
32
03345
APOTIK TINA
33
03343
34
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/20/012012
01/01/2012
31/12/2012
PER/21.012012
01/01/2012
31/12/2012
DR HMP SIREGAR
PER/16/012012
01/01/2012
31/12/2012
7000
HJ YURNI
PER/23/122008
01/01/2009
31/12/2009
7000
20352
H. RIDWAN IBRAHIM
PER/25/012012
01/01/2012
31/12/2012
7000
JL KLY SUDARSO NO 85
-081361701185 20352
LESTIANA TARIGAN
PER/27/012012
01/01/2012
31/12/2012
7000
APOTIK WINDA
JL BESAR MARELAN NO 11
061-6850200
20352
PER/28/012012
01/01/2012
31/12/2012
7000
03347
OPTIK 2000
JL KRAKATAU NO 102
061-6618190
20352
L. EFFENDY TJENDRAJAJA, SE
PER/23/012012
01/01/2012
31/12/2012
7000
35
06963
OPTIK BONIA
061-77372885 20352
BUNGANTA BR SIHOTANG
PER/24/012012
01/01/2012
31/12/2012
36
03346
OPTIK MARELAN
JL BESAR MARELAN NO 17
061-6850200
20352
DR H ZULCHAIZAR B
PER/22/012012
01/01/2012
31/12/2012
7000
37
04055
RI244010
7000
PKR102001
Halaman :
Tanggal :
26/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/18/122012
01/01/2013
30/06/2013
7000
PER/19/122012
01/01/2013
30/06/2013
7000
PER/16/122012
01/01/2013
30/06/2013
7000
SUPARMAN PERANGIN-ANGIN,
AMK
PER/13/122012
01/01/2013
30/06/2013
7000
DR MASRO TAMBUNAN
PER/15/122012
01/01/2013
30/06/2013
7000
20761
DR WILSON RIMBA
PER/06/122012
01/01/2013
30/06/2013
7000
0813-62071602 20551
PER/14/122012
01/01/2013
30/06/2013
7000
BP TRIDARMA
20772
DR. K. LALITA
PER/09/122012
01/01/2013
30/06/2013
7000
05463
BP/ RB SEMPURNA
061-91047120 20773
DR ESRA F. SEMBIRING
PER/20/122012
01/01/2013
30/06/2013
7000
10
04164
JL MEDAN BINJAI KM 12
20761
PER/04/122012
01/01/2013
30/06/2013
7000
11
04172
20853
PER/11/122012
01/01/2013
30/06/2013
9000
12
04165
20761
PER/17/122012
01/01/2013
30/06/2013
7000
13
04167
20771
DR ERINSON SINAGA
PER/08/122012
01/01/2013
30/06/2013
7000
14
04174
KLINIK CHYNTIA
20858
PER/12/122012
01/01/2013
30/06/2013
7000
15
04170
20761
IR ABIDAH
PER/07/122012
01/01/2013
30/06/2013
7000
16
06278
KLINIK KELIAT
-08126368799 20552
PERATEN NATALIA
PER/10/122012
01/01/2013
30/06/2013
7000
17
04133
20762
PER/05/122012
01/01/2013
30/06/2013
7000
18
04179
RS PERTAMINA
20855
PER/20/122011
01/01/2012
31/12/2012
7000
19
04178
RS DR DJOELHAM BINJAI
20761
PER/01/102012
01/01/2012
31/12/2012
7000
20
05851
RS ARTHA MEDICA
061-8827277
20773
061-8830757
21
07172
RSU BIDADARI
061-8830003
20761
061-8821030
22
07920
RSU LATERSIA
061-8829788
20761
061-8822565
23
07219
APOTEK BIDADARI
061-8830003
20761
061-8821030
24
04180
061-8822813
20761
25
04341
OPTIK PATEN
-061-8821454 20761
ARIFIN LEO
26
05628
TAN OPTIK
0620-20709
TENG HOK
04171
BP HARAPAN BERSAMA
20854
04131
BP HISARMA
20852
DR JM SILITONGA
04166
BP KURNIA SERASI
JL MEDAN BINJAI KM 12
20761
TAN ERFI
05860
BP MUTIARA
-081361222830 20857
04175
BP RIDHO II
20771
04132
BP SARANA
06469
BP SEHAT SEHATI
06470
RI244010
20857
DR ARUSTA TARIGAN
v
v
PER/23/022011
01/01/2011
28/02/2011
PER/19/122011
01/01/2012
31/12/2012
PER/01/062012
01/06/2012
31/12/2012
PER/22/122011
01/01/2012
31/12/2012
7000
PER/21/122011
01/01/2012
31/12/2012
7000
PER/23/122011
01/01/2012
31/12/2012
7000
PER/24/122011
01/01/2012
31/12/2012
7000
PKR102001
Halaman :
Tanggal :
27/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/07/012013
01/01/2013
31/12/2013
7000
PER/04/012013
01/01/2013
31/12/2013
10000
PER/03/012013
01/01/2013
31/12/2013
7000
BD HJ ZURMIATI
PER/02/012013
01/01/2013
31/12/2013
7000
0813-63927176 25553
PER/43/032012
01/03/2012
28/02/2013
7000
25654
DR DONA H
PER/48/042012
01/04/2012
31/03/2013
7000
DR GUSWIN
25391
KOPKARJAM
PER/28/012013
01/01/2013
31/12/2013
7000
07836
DR HESTY LOVIANDA
25391
DR HESTY LOVIANDA
PER/47/042012
01/04/2012
31/03/2013
7000
00275
0751-73070
25391
DR HJ LILI IRAWATI
PER/20/012013
01/01/2013
31/12/2013
15000
10
07811
JL KURANJI NO 33 PADANG
25392
PER/45/042012
01/04/2012
31/03/2013
7000
11
04025
DR MIFTAH IRRAHMAH
25391
PER/29/012013
01/01/2013
31/12/2013
7000
12
00279
DR RAHMADINI
--
25391
DR RAHMADINI
PER/23/012013
01/01/2013
31/12/2013
10000
13
00280
DR RATNA SARI
--
25391
KOPKARJAM
PER/24/012013
01/01/2013
31/12/2013
7000
14
04203
DR RIKA HARYANTI
-684232
25552
DR RIKA HARYANTI
PER/23/012012
01/01/2012
31/12/2012
7000
15
00281
DR RINITA AMELIA
--
25391
DR RINITA AMELIA
PER/25/012013
01/01/2013
31/12/2013
7000
16
07776
DRG MASWIR
0812-6740776 25553
DRG MASWIR
PER/44/032012
01/03/2012
28/02/2013
7000
17
07876
25661
PER/49/042012
01/04/2012
31/03/2013
7000
18
07966
25116
PER/53/072012
01/07/2012
30/06/2013
20000
19
08144
ETI MEDIKA
25586
HEIZY PRIASTUTI
PER/64/122012
01/12/2012
30/11/2013
14000
20
07898
25553
DR SYAFRINAWATI
PER/51/052012
01/05/2012
30/04/2013
7000
21
00277
0751-63162
25391
DR FERI MULYANI
PER/22/012013
01/01/2013
31/12/2013
7000
22
00274
-0751-59341
25394
DR MARNI RAHIM
PER/19/012013
01/01/2013
31/12/2013
7000
23
03155
KLINIK EDELWEIS
-08126606954 25581
DR ARTATI SURYANI
PER/27/012013
01/01/2013
31/12/2013
7000
24
04742
KLINIK FITRIA
RAHMI FITRIASARI
PER/30/012013
01/01/2013
31/12/2013
12000
04670
BD HJ OSMIRYETTI, AMK
KAMPUNG JUA RT II RW I
25392
BD HJ OSMER YETTI
96020
0751-8229453 25392
00283
--
25393
03690
BIDAN ZURMIATI
JL ADINEGORO NO 19 PADANG
25392
07775
07875
DR DONA HAMRITA
03290
RI244010
25391
PKR102001
Halaman :
Tanggal :
28/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/31/012013
01/01/2013
31/12/2013
40000
PER/32/012013
01/01/2013
31/12/2013
70000
PER/21/012013
01/01/2013
31/12/2013
10000
DR IRENE SUSILO
PER/26/012013
01/01/2013
31/12/2013
7000
PER/33/012013
01/01/2013
31/12/2013
7000
25392
HJ BD ROSDA MARTA
7000
25391
BD HJ OSMER YETTI
7000
25391
7000
25391
7000
999901
25392
XXXXXXX
35
04745
RB CEMPAKA INDAH
-08126610465 25392
DR MARNI RAHIM
PER/13/012013
01/01/2013
31/12/2013
7000
36
07835
RB MELATI
25392
SULASTRI SE
PER/46/042012
01/04/2012
31/03/2013
7000
37
06282
RB MITRA AYU
0751-61206
25391
HJ EDA SURYATI
PER/12/012013
01/01/2013
31/12/2013
6000
38
05199
RB MUTIARA BUNDA
25393
BIDAN ZULMAIDIAR
PER/10/012013
01/01/2013
31/12/2013
7000
39
00282
RB NAUVAL MEDIKA
--
25392
BD HJ SYARWARNI
PER/01/012013
01/01/2013
31/12/2013
7000
40
04207
RB PERMATA BUNDA I
25552
PER/01/012010
01/01/2010
31/12/2010
7000
41
04208
RB PERMATA BUNDA II
25552
DR RIKA HARYANTI
B/049/012012
01/01/2012
31/12/2012
7000
42
96289
-08126735644 25391
DARLIANI
PER/06/012013
01/01/2013
31/12/2013
6000
43
6021
0751-22080
25116
PER/09/012013
01/01/2013
31/12/2013
12000
44
04671
RB ROSDA MARTA
25394
BD HJ ROSDA MARTA
PER/08/012013
01/01/2013
31/12/2013
7000
45
04205
RB SITI RESWARI
25391
PER/05/012013
01/01/2013
31/12/2013
7000
46
06521
RSB AN-NISA
25391
PER/11/012013
01/01/2013
31/12/2013
6000
47
47421
RS BHAYANGKARA PADANG
25116
PER/14/012012
01/01/2012
31/12/2012
18000
48
04540
RS REKSODIWIRYO
JL DR WAHIDIN NO 1 PADANG
25394
DETASEMEN KESEHATAN
WILAYAH TK III 01.06.01
PER / 15 / 012012
01/01/2012
31/12/2012
PER/13/012010
01/01/2010
31/03/2011
25
03156
25392
DRG IRSYADI
26
03157
25394
27
00276
25391
DR MARTHA E
28
03154
-0751-893382 25391
29
07170
0751-32200
25392
30
94671
KOSONG
31
94670
KOSONG
32
9999905
33
9999907
34
RI244010
10000
40000
PKR102001
Halaman :
Tanggal :
29/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
49
47589
RSUD PARIAMAN
JL PROF M YAMIN, SH NO 5
-075191428
25552
50
04006
KLINIK INSANI
JL PROKLAMASI NO 32 B PADANG
25392
DR ERMAWATI, SP OG
PER/40/012012
01/01/2012
31/12/2012
7000
51
07373
RS SELAGURI
0751-33010
25116
0751-840051
PER/29/012012
01/01/2012
31/12/2012
20000
52
07880
JLN JENDRAL SUDIRMAN SAGO KENAGARIAN SAGO-SALIDO KEC IV JURAI KAB PESISIR SELATAN
25665
MAWARDI, SE.AKT.MM
PER/50/042012
01/04/2012
31/03/2013
53
00285
-0851-32373
25393
YAYASAN RS M DJAMIL
PER/48/042010
01/04/2010
31/12/2010
54
07371
JL DR WAHIDIN NO.1
0751-31386
25116
PER / 15 /012012
01/01/2012
31/12/2012
55
08112
0751-23620
25112
RESWANDI.SSI.APT
PER/61/112012
01/11/2012
31/10/2013
56
00287
-0751-26229
25393
KOPKARJAM
PER/17/012013
01/01/2013
31/12/2013
7000
57
04007
APOTIK INSANI
JL PROKLAMASI NO 32 B PADANG
0751-9056768 25129
PER/18/012013
01/01/2013
31/12/2013
7000
58
94743
25391
YAYASAN BAITURRAHMAH
59
07102
OPTIK CENTRAL
0752-7007975 25652
PER / 56 / 072010
01/07/2010
31/12/2011
60
042750
OPTIK CITRA
-0751-25706
25391
HJ MAYAASTUTI, AMD.RO
PER/15/012013
01/01/2013
31/12/2013
12000
61
00288
OPTIK MINANG
-0751-23248
25391
H FERISYAL RAMLI
PER/14/012013
01/01/2013
31/12/2013
14000
62
07967
OPTIK MUSTIKA
25552
CAHAYAWATI
PER/54/072012
01/07/2012
30/06/2013
63
00290
OPTIK TIMUR
-0751-26124
25392
PER/16/012013
01/01/2013
31/12/2013
7000
64
07909
25391
DR HJ MARNI RAHIM
PER/52/052012
01/05/2012
30/04/2013
10000
65
07774
0751-38772
25116
HJ DESMANIAR DJOHOR
PER/41/012012
01/03/2012
28/02/2013
RI244010
PEMDA PARIMAN
v
v
7000
PKR102001
Halaman :
Tanggal :
30/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/31/092012
01/09/2012
31/08/2013
7000
PER/33/082011
01/08/2011
31/07/2012
7000
PER/33/082011
01/08/2011
31/07/2012
7000
PER/33/082011
01/08/2011
31/07/2012
7000
PER/33/082011
01/08/2011
31/07/2012
7000
26473
PER/33/082011
01/08/2011
31/07/2012
7000
26452
PER/33/082011
01/08/2011
31/07/2012
7000
PER/33/082011
01/08/2011
31/07/2012
7000
PER/33/082011
01/08/2011
31/07/2012
7000
PER/33/082011
01/08/2011
31/07/2012
7000
DR. A. TAUFIK
PER/27/08/2012
01/08/2012
31/07/2013
7000
PER/15/042012
01/04/2012
31/03/2013
0852-63111999 26161
PER/26/072012
01/08/2012
31/07/2013
7000
26151
DR SONTA THEMIARTO
PER/39/112012
01/11/2012
31/10/2013
7000
-08126608614 25394
PER/11/03-2010
01/03/2010
31/08/2010
5000
05945
26373
PER/06/022012
01/02/2012
31/01/2013
3000
17
05693
26251
PER/32/082012
01/08/2012
31/07/2013
2500
18
06257
26251
PER/28/082012
01/08/2012
31/07/2013
3000
19
06139
DR. HIDAYAH
26352
DR. HIDAYAH
PER/12/042012
01/04/2012
31/03/2013
4000
20
06642
DR. MARNIYANTI
26361
DR. MARNIYANTI
PER/23/062012
01/06/2012
31/05/2013
2000
21
05954
DR. SYAHRIL.S
26373
DR. SYAHRIL.S
PER/22/072012
01/07/2012
30/06/2013
5000
22
07866
DRG MESGITO
0752-21185
26151
PER/16/052012
01/05/2012
30/04/2013
7000
23
06841
KLINIK ALIF
27291
PER/11/042012
01/04/2012
31/03/2013
3000
24
04137
26151
PER/30/092012
01/09/2012
31/08/2013
10000
07132
04262
PUSKESMAS IV KOTO
04266
26352
YUSLAN LUBIS
-07527000799 26452
26452
04263
PUSKESMAS MALALAK
26452
04271
PUSKESMAS MANGGOPOH
26452
04267
PUSKESMAS MANINJAU
-075261007
04264
PUSKESMAS MATUR
-075261396
04253
04265
PUSKESMAS PALEMBAYAN
26452
10
04273
PUSKESMAS PALUPUH
26473
11
05355
DR A TAUFIK
JL VETERAN NO 1B PAYAKUMBUH
-0752-23577
1525
12
07840
DR ARDONI
0813-63573630 27261
13
07982
DR HENDRI RUSDIAN
14
07271
DR SONYA THEMIARTO
15
06536
16
RI244010
4000
PKR102001
Halaman :
Tanggal :
31/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
25
07433
26
08109
27
07434
28
0812-6619891 26151
26111
DR RATNA JUWITA
0812-6619891 26151
04254
PUSKESMAS BASO
-0752426169
29
04270
30
04255
PUSKESMAS BIARO
JL RAYA BUKTINGGI-PAYAKUMBUH KM 7
-0752426241
31
04258
PUSKESMAS KAPAU
32
04256
PUSKESMAS LASI
33
04259
PUSKESMAS MAGEK
34
04260
35
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/40/112012
01/11/2012
31/10/2013
5000
3500
PER/38/112012
01/11/2012
31/10/2013
PER/41/112012
01/11/2012
31/10/2013
PER/35/082011
01/08/2011
31/07/2012
7000
PER/33/08/20111
01/08/2011
31/07/2012
7000
PER/35/082011
01/08/2011
31/07/2012
7000
PER/33/082011
01/08/2011
31/07/2012
7000
-0752426241
PER/33/082011
01/08/2011
31/07/2012
7000
PER/33/082011
01/08/2011
31/07/2012
7000
-0752627180
PER/33/082011
01/08/2011
31/07/2012
7000
04268
-075261107
PER/33/082011
01/08/2011
31/07/2012
7000
36
04257
-0752628713
PER/33/082011
01/08/2011
31/07/2012
7000
37
04261
-0752691142
PER/33/082011
01/08/2011
31/07/2012
7000
38
04272
PUSKESMAS TIKU
26473
PER/33/082011
01/08/2011
31/07/2012
7000
39
04138
26471
PER/02/012012
01/03/2012
28/02/2013
7000
40
00293
-075221720
26151
-075221321
PEMDA BUKITTINGGI
PER/42/112012
01/11/2012
31/10/2013
7000
41
07281
0752-82046
27151
PER/21/052012
01/05/2012
30/04/2013
42
06628
0753-20033
26372
PER/01/012012
01/01/2012
31/12/2012
7000
43
04705
26151
PER/34/092012
01/09/2012
31/08/2013
70
44
94956
JL PEMUDA NO 14 PAYAKUMBUH
26151
PER/25/072012
01/07/2012
30/06/2013
7000
45
04627
-NULL
27151
PER/50/122010
01/12/2010
30/11/2011
7000
46
06272
0752-21185
26181
PER/37/082012
01/08/2012
31/07/2013
3000
47
06537
0751-8270344 25394
0751-443115
PER/12/03-2010
01/03/2010
28/02/2011
48
00294
-0753-65015
26371
-075365015
08/02/2012
01/02/2012
31/01/2013
49
94957
26151
50
04706
27265
RI244010
6000
7000
70
APOTIK RS PROF DR MA
HANAFIAH S.M BATUSANGKAR
PER/35/092012
01/09/2012
31/08/2013
70
PKR102001
Halaman :
Tanggal :
32/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/36/102012
01/10/2012
30/09/2013
7000
PER/46/122012
01/12/2012
30/11/2013
7000
PER/51/122010
01/12/2010
30/11/2011
7000
PER/26/072012
01/07/2012
30/06/2013
3500
26366
PER/18/022012
01/02/2012
31/01/2013
7000
26151
PER/03/012012
01/02/2012
31/01/2013
7000
26352
PER/17/042012
01/03/2012
28/02/2013
-NULL
26452
HADISWAN
PER/43/112012
01/11/2012
31/10/2013
7000
OPTIK MONICA
26151
NESSYA NELTI
PER/22/052012
01/05/2012
30/04/2013
7000
OPTIK RAMLI
-0752-22972
26192
H. RAMLI
PER/29/082012
01/08/2012
31/07/2013
7000
51
00296
-0752-626504 26151
SRI WAHYUNI
52
00295
-0752-21272
26151
53
04626
-NULL
27151
54
04958
JL PEMUDA NO 14 PAYAKUMBUH
26151
55
03685
-0753-65015
56
04139
57
07867
58
04625
OITI OPTICAL
59
04310
60
00297
RI244010
HARI BUKA
PPK II
PKR102001
Halaman :
Tanggal :
33/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
00303
27451
05399
BIDAN GUSNIATI
27351
05323
BIDAN HJ DJUSNA
27366
05135
DR EDWIN SUPRAYOGI
27351
06433
DR SALMA LIRA
-081363880309 27564
05909
DR SUJITO
00298
DR. AZRA
07139
DR. DENDI
07747
10
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/06/012013
01/01/2013
31/03/2013
PER/45/122011
01/01/2012
31/12/2012
7000
PER/31/102011
01/11/2011
31/10/2012
7000
PER/05/012013
01/01/2013
31/03/2013
7000
PER/03/012013
01/01/2013
31/03/2013
7000
27355
PER/04/012013
01/01/2013
31/03/2013
7000
27351
PER/01/012013
01/01/2013
31/03/2013
7000
-085263230332 27351
DR. DENDI
PER/07/012012
01/02/2012
31/01/2013
7000
-08116609920 27451
DR.FITRA NEZA
PER/11/022012
01/03/2012
31/12/2012
7000
07269
-081363430544 27352
PER/17/052012
01/05/2012
31/12/2012
7000
11
07748
-085274265498 27351
PER/12/022012
01/03/2012
31/12/2012
7000
12
08017
DR. RAFLES
-081268463895 27673
DR. RAFLES
PER/22/082012
01/09/2012
31/12/2012
7000
13
00299
27451
PER/02/012013
01/01/2013
31/03/2013
14
07138
-08126631776 27351
PER/08/012012
01/02/2012
31/01/2013
7000
15
08004
-085263471364 27776
PER/21/072012
01/08/2012
31/12/2012
7000
16
07136
-085278816168 27355
PER/09/012012
01/02/2012
31/01/2013
7000
17
07202
-08126730873 27352
PER/15/032012
01/04/2012
31/12/2012
7000
18
07268
KLINIK AL-THAF
0755-324102
27351
KLINIK ALTHAF
PER/07/012013
01/01/2013
31/03/2013
19
07745
KLINIK ASRI
0754-21238
27451
PER/09/022012
01/03/2012
31/12/2012
20
04757
DR FITRA NEZA
26151
21
99998
CABANG SETEMPAT
22
06438
27351
PER/38/122012
01/01/2012
31/12/2012
7000
23
00301
RSUD SAWAHLUNTO
27451
PER/40/122012
01/01/2012
31/12/2012
7000
24
00300
RSUD SOLOK
27361
PER/38/122011
01/01/2012
31/12/2012
7000
25
05138
27451
PER/32/102011
01/11/2011
31/10/2012
7000
7000
v
v
7000
70
7000
RI244010
PKR102001
Halaman :
Tanggal :
34/239
15-01-2013
16:22:40
PEMILIK
NO
NO. PPK
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
26
06458
0755-70462
27388
27
05137
27451
28
04543
27572
29
04542
APOTIK PELENGKAP KPN RSUD SAWAHLUNTO JL KARTINI NO 18 KOMPLEK RSUD SAWAH LUNTO
27562
30
04225
27356
RI244010
HARI BUKA
PPK II
OPT LAB PEM ABRI BUMN SWASTA
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/37/122012
01/01/2012
31/12/2012
PER/34/122012
01/01/2012
31/12/2012
7000
PER/36/122012
01/01/2012
31/12/2012
7000
PER/12/012008
01/01/2008
31/12/2008
7000
PER/35/122011
01/01/2012
31/12/2012
7000
PKR102001
Halaman :
Tanggal :
35/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
00383
28382
04429
28382
00384
PKM TAPUNG
05657
07623
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
31/12/2013
7000
PER/01/012013
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
KAMIS, JUM'AT,
GIGI (SHIFT 1,SHIFT 2.,SHIFT
SABTU
2)
PER/12/012013
01/01/2013
31/12/2013
7000
28382
PER/09/012013
01/01/2013
31/12/2013
7000
-08127534107 28371
PER/85/072012
01/07/2012
30/06/2013
7000
PUSKESMAS KANDIS
-08127514641 28661
PUSKESMAS
PER/16/012013
01/01/2013
31/12/2013
7000
07862
PUSKESMAS MINAS
-081378412200 28661
DR HIDAYATI JASRI
PER/66/05212
01/05/2012
30/04/2013
7000
06140
PUSKESMAS PUJUD
0811-
28991
01/04/2012
31/03/2013
7000
07315
28371
PER/74/062012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
GIGI (SHIFT 1), SALIN (SHIFT
KAMIS, JUM'AT,
1)
SABTU
01/06/2012
31/05/2013
7000
06659
-08127621923 28371
M SYAFE'I, SKM
PER/75/062012
01/06/2012
31/05/2013
5000
10
03954
BP BUDI MULYA
PANGKALAN KERINCI
0761-493380
28382
BP BUDI MULYA
PER/03/012013
01/01/2013
31/12/2013
9000
11
02941
BP CENDANA HUSADA
0761-860479
28382
BP CENDANA HUSADA
PER/07/012013
01/01/2013
31/12/2013
7000
12
07060
BP DANIEL
28661
PER/15/012013
01/01/2013
31/12/2013
7000
13
06629
BP MINAS SEHAT
0761-598169
28381
PER/63/052012
01/05/2012
30/04/2013
5000
14
03242
BP NAYAKA HUSADA
-08126805228 28382
15
06446
BP PERMATA HUSADA
28371
16
06860
BP RIZKI MEDICAL
0813-65307308 28800
17
06436
BP UWA MEDICA
18
07423
BP. BETESDA
19
07624
20
10000
PER/11/012013
01/01/2013
31/12/2013
PER/14/012013
01/01/2013
31/01/2013
500
PER/103/102012
01/10/2012
30/09/2013
5000
PER/10/012013
01/01/2013
31/12/2013
PER/88/072012
01/07/2012
30/06/2013
5000
RIDDAYANI, SKM.M.KES
PER/17/012013
01/01/2013
31/12/2013
7000
-085278636426 28371
PER/38/032012
01/03/2012
28/02/2013
7000
28661
PER/102/102012
01/10/2012
30/09/2013
5000
JL RAYA KM 5 PERAWANG
0761-92978
28772
0761-91573
HM BASYIR THALIB
PER/93/082012
01/08/2012
31/07/2013
7000
04882
37152
PER/53/042012
01/04/2012
31/03/2013
7000
06957
BP/RB. RAUDAH
28381
DR. GUSRIANTI
PER/105/122012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
GIGI (SHIFT 1), SALIN (SHIFT
KAMIS, JUM'AT,
1,SHIFT 2)
SABTU
01/12/2012
30/11/2013
9000
HERMAN, SAG
0761-3044777 28461
0852-65525266 28371
28371
07737
21
06852
22
06274
23
24
RI244010
5000
PKR102001
Halaman :
Tanggal :
36/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
25
05426
BP/RB. FELLITA
0761-7060561 28382
26
06771
0812-7587303 28661
27
07151
DR BAMBANG TRIONO
0812-7583850 28454
DR BAMBANG TRIONO
28
06275
0859-73276000 28371
29
00370
0761-23020
28452
DR A PURBA
30
03240
0813-65678502 28382
31
07736
DR. DEFRI
-085263005508 28371
DR. DEFRI
32
06811
DR. GUSRIANTI
-085278131951 28381
DR. GUSRIANTI
33
04883
0812-68837000 28671
DR KURNIA
34
06747
DR. H.MUNADHIRIN
0813-65512794 28671
DR H MUNADHIRIN
35
05324
28382
36
07438
0812-88579119 28800
DR RACHMAD SURYAWAN
37
05107
0813-71008910 37152
DR RAHMAT SUSANTO
38
06805
39
04027
JL SISINGAMANGARAJA NO 25 B BANGKINANG
-0762-323304 28381
40
04923
41
04924
42
04949
43
07150
44
06737
45
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/55/042012
01/04/2012
31/03/2013
PER/98/082012
01/08/2012
31/07/2013
7000
PER/41/032012
01/03/2012
28/02/2013
7000
PER/100/092012
01/09/2012
31/08/2013
7000
PER/64/052012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
GIGI (SHIFT 1), SALIN (SHIFT
KAMIS, JUM'AT,
1)
SABTU
01/05/2012
30/04/2013
9000
PER/13/012013
01/01/2013
31/12/2013
7000
PER/37/032012
01/03/2012
28/02/2013
7000
PER/101/092012
01/09/2012
31/08/2013
5000
PER/57/042012
01/04/2012
31/03/2013
7000
PER/87/072012
01/07/2012
30/06/2013
7000
PER/104/122012
01/12/2012
30/12/2012
7000
PER/96/082012
01/08/2012
31/07/2013
PER/97/082012
01/08/2012
31/07/2013
7000
PER/95/082012
01/08/2012
31/07/2013
5000
DR LISNA EFENDI
PER/52/042012
01/04/2012
31/03/2013
7000
PER/58/042012
01/04/2012
31/03/2013
7000
37152
PER/29/022012
01/02/2012
31/01/2013
7000
37152
DR. HJ.DAHWIANA
PER/62/052012
01/05/2012
30/04/2013
7000
0812-7690696 28557
DR FINALDI NASIR
PER/40/032012
01/03/2012
28/02/2013
7000
0812-6840777 28381
PER/86/072012
01/07/2012
30/06/2013
5000
04600
RB. DAFFA
0813-71702882 28382
DR YANI
PER/76/062012
01/06/2012
31/05/2013
46
03952
0761-37564
28382
PER/05/012013
01/01/2013
31/12/2013
8000
47
04486
0761-556111
28382
DR MISBAH
PER/26/022012
01/02/2012
31/01/2013
9000
48
04728
37152
DR. ALIMORA
RI244010
7000
7000
7000
PKR102001
Halaman :
Tanggal :
37/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
7000
49
04727
37152
50
00373
0761-22426
28382
51
04430
JL DIPONEGORO NO 1 PEKANBARU
28382
52
07359
RS AWAL BROS
0761-47333
28381
0761-47222
53
06176
RS EFARINA
0761-494500
28800
0761-493981
JR SARAGIH,SH MM
54
04867
0761-49348
28382
0761-493345
55
06319
0761-35464
28381
0761-839114
56
04146
0761-855670
28382
57
00377
CITRA OPTICAL
0811-756022
28382
HOVERI BOUMIDIEN
58
04601
OPTIK JAILANA
0813365618893
28382
IR ACHIRUDIN JAILANA
59
0761-47333
28381
0761-47222
60
JL SUDIRMAN NO 410
0761-35464
28381
0761-839114
RI244010
HARI BUKA
PPK II
DR. ALIMORA
PER/60/042012
01/04/2012
31/03/2013
7000
PER/51/042012
01/04/2012
31/03/2013
7000
PER/77/062012
01/06/2012
31/05/2013
50000
PER/65/052012
01/05/2012
30/04/2013
UJANG MALIK SE
PER/28/022012
01/02/2012
31/01/2013
PROF DR TABRANI
PER/94/082012
01/09/2012
31/08/2013
PER/39/032012
01/03/2012
28/02/2013
7000
PER/61/042012
01/04/2012
31/03/2013
7000
PER/78/062012
01/06/2012
31/05/2013
7000
82/IKS/0612
01/08/2012
31/07/2013
PROF. DR TRABRANI
169/IKS/052012
01/05/2012
30/04/2013
v
v
7000
PKR102001
Halaman :
Tanggal :
38/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
01/04/2012
31/03/2013
10000
01/12/2011
30/11/2012
10000
PER/36/032012
01/04/2012
31/03/2013
7000
01/05/2012
30/04/2013
10000
PER/41/032012
01/04/2012
31/03/2013
7000
PER/45/032012
01/07/2012
30/06/2013
7000
0771-484203
PEMERINTAH KABUPATEN
BINTAN
PER/46/032012
01/07/2012
30/06/2013
-08126181321 29152
PER/52/072012
01/09/2012
31/08/2013
15000
0771-441744
29112
0771-44174
PER/39/032012
01/04/2012
31/03/2013
7000
JL PEMUDA NO 33
0771-21201
29123
0771-21201
HJ DARMAYANTI, KLINIK
HUSADA
PER/32/032012
01/04/2012
31/03/2013
7000
00307
0771-484427
29152
0771-484427
PER/40/032012
01/04/2012
31/03/2013
10000
12
00306
-081372490663 29152
PER/33/032012
01/04/2012
31/03/2013
7000
13
05201
0771-61118
29152
PEMERINTAH KABUPATEN
BINTAN
PER/19/102011
01/10/2011
30/09/2012
7000
14
07729
0771-61664
29152
RSUD KABUPATEN
BINTAN
01/01/2012
31/12/2012
7000
15
00308
RSUD TG PINANG
0771-313000
29122
PER/35/032012
01/04/2012
31/03/2013
7000
16
05340
0771-482795
29152
0771-482796
PER/30/122011
01/12/2011
30/11/2012
10000
17
00312
JL BINTAN 656-658
0771-21091
29122
PER/37/032012
01/04/2012
31/03/2013
7000
18
05339
INSTALASI FARMASI RSUP KEPULAUAN RIAU JL INDUN SURI SIMPANG BUSUNG TANJUNG UBAN
TANJUNG UBAN
0771-482655
29152
PER/29/122010
01/12/2010
30/11/2011
10000
19
07901
0771-27743
29151
0771-27743
ELVIKA RAMON
PER/47/052012
01/05/2012
30/04/2013
20
06645
APOTEK MULIA
0771-81650
29152
0771-81650
PER/44/032012
01/06/2012
31/05/2013
10000
21
00313
SURYA OPTICAL
0771-21880
29122
0771-317165
TAN WITANTO
PER/53/072012
01/08/2012
31/07/2013
7000
03959
JL SUDIRMAN 795
0771-211632173
29122
05338
0771-482655
29152
00314
PUSKESMAS KIJANG
0771-61118
29151
PUSKESMAS KIJANG
06152
0771-26329
29192
00318
JL IR H JUANDA NO. 1
0771-21642
29112
06725
0771-484203
29152
06725
0771-484203
29152
03901
04530
KLINIK ANANDA
10
00304
11
RI244010
v
v
7000
PKR102001
Halaman :
Tanggal :
39/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
00334
PUSKESMAS SAMBAU
0778-761346
05361
BP ALAM SEHAT
0778-8098444 29431
05862
0778-711569
06205
0778-3582757 29439
03147
0778-427854
0778-432833
04435
0778-7020233 14035
05120
0778-471295
29433
03142
0778-452941
03140
0778-431974
10
00330
11
14035
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/47/122012
01/01/2013
31/12/2013
7000
PER/34/122012
01/01/2013
31/12/2013
10000
PER/35/122012
01/01/2013
31/12/2013
7000
PER/40/12/2012
01/01/2013
31/12/2013
7000
01/01/2013
31/12/2013
PER/39/122012
01/01/2013
31/12/2013
7000
0778-371261
PER/53/122012
01/01/2013
31/12/2013
7000
14035
0778-371261
PER/51/2012
01/01/2013
31/12/2013
9700
14035
0778-371261
PER/52/122012
01/01/2013
31/12/2013
7105
JL AHMAD YANI PANBIL KOMERSIAL AREA BLOK A/4 MUKA 0778-5156611 14035
KUNING
0778-371261
PER/48/122012
01/01/2013
31/12/2013
13165
03138
0778-323833
14035
0778-371261
PER/50/122012
SENIN, SELASA, RABU, UMUM (SHIFT I,SHIFT II),
GIGI (SHIFT 1,SHIFT I,SHIFT
KAMIS, JUM'AT,
II)
SABTU
01/01/2013
31/12/2013
12002
12
03139
0778-450227
14035
0778-371261
PER/49/122012
01/01/2013
31/12/2013
9207
13
03148
0778-361909
14035
0778-432833
PER/38/122012
SENIN, SELASA, RABU, UMUM (SHIFT I,SHIFT II),
GIGI (SHIFT I), SALIN (SHIFT
KAMIS, JUM'AT,
I)
SABTU, MINGG
01/01/2013
31/12/2013
9050
14
06145
BP HARAPAN KITA
0778-8099568 29428
0778-474396
PER/41/122012
SENIN, SELASA, RABU, UMUM (SHIFT I,SHIFT II),
GIGI (SHIFT I), SALIN (SHIFT
KAMIS, JUM'AT,
I)
SABTU, MINGG
01/01/2013
31/12/2013
7000
15
07408
0778-361475
29439
PER/45/122012
01/01/2013
31/12/2013
9000
16
07098
29432
PER/44/122012
SENIN, SELASA, RABU, UMUM (SHIFT I,SHIFT II),
GIGI (SHIFT I), SALIN (SHIFT
KAMIS, JUM'AT,
I)
SABTU, MINGG
01/01/2013
31/12/2013
7105
17
06992
0778-459174
29432
PER/43/122012
01/01/2013
31/12/2013
11000
18
06298
0778-8096104 29432
0778-474396
PER/42/122012
01/01/2013
31/12/2013
9800
19
07089
BP MERAH DELIMA
0778-7041049 29432
MERAH DELIMA CV
PER/46/122012
SENIN, SELASA, RABU, UMUM (SHIFT I,SHIFT II),
GIGI (SHIFT I), SALIN (SHIFT
KAMIS, JUM'AT,
I)
SABTU, MINGG
01/01/2013
31/12/2013
7000
20
06442
BP PRAYSELA
0778-495663
29432
0778-495671
PER/36/122012
SENIN, SELASA, RABU, UMUM (SHIFT I,SHIFT II),
GIGI (SHIFT 2), SALIN (SHIFT
KAMIS, JUM'AT,
1,SHIFT 2)
SABTU, MINGG
01/01/2013
31/12/2013
7000
21
06338
BP TANJUNG PIAYU
0778-5118810 29432
0778-371001
PER/54/122012
SENIN, SELASA, RABU, UMUM (SHIFT I,SHIFT II),
GIGI (SHIFT I), SALIN (SHIFT
KAMIS, JUM'AT,
I)
SABTU
01/01/2013
31/12/2013
7000
22
06845
0778-495684
29432
DRG WT LUSIANA
01/01/2013
31/12/2013
24000
23
04692
9999
MINA
24
07167
0778-431777
29428
0778-430777
29431
14035
13000
70
PER/70/122011
01/01/2012
31/12/2012
0778-454055
RI244010
PKR102001
Halaman :
Tanggal :
40/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
25
05344
RS BUDI KEMULIAAN
26
05352
RS CHARIS MEDIKA
27
07090
JL SERAYA NO.1
0778-457333
28
05585
0778-6004000 29432
29
00322
0778-461415
29431
0778-462169
30
05402
0778-426865
29453
0778-454055
31
05403
32
00329
INTERNATIONAL OPTICAL
0778-426893
33
00328
34
00327
SALLY OPTICAL
35
07631
36
06533
37
38
0778-454044
29453
29453
RS HARAPAN BUNDA
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
31/12/2012
PER/68/122011
PER/71/122011
01/01/2012
31/03/2012
PER/69/122011
01/01/2012
31/12/2012
PER/72/122011
01/01/2012
30/06/2012
PER/59/122012
01/01/2013
31/12/2013
v
v
PER/15/022011
01/01/2011
31/12/2011
PER/16/022011
01/01/2011
31/12/2011
CHARIS MEDIKA
14035
0778-426893
PER/130/122010
01/01/2011
31/12/2011
0778-455664
14035
0778-455664
PER/117/122010
01/01/2011
31/12/2011
0778-457521
14035
PER/56/122012
01/01/2013
31/12/2013
WELLNESS OPTICAL
0778-455344
29432
SUI KIT
PER/57/122012
01/01/2013
31/12/2013
0778-473086
29432
0778-473087
GATSU CV
PER/74/122011
01/01/2012
31/12/2012
0778-431777
29428
0778-430777
DR WIDYA PUTRI
PER/44/022009
01/03/2009
28/02/2010
0778-371003
29433
0778-371001
PER/25/102012
01/11/2012
31/10/2013
RI244010
JUMLAH
TTG
PKR102001
Halaman :
Tanggal :
41/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/01/082012
01/08/2012
31/07/2013
5000
PER/02/042012
01/04/2012
31/03/2013
10000
PER/02/062012
01/06/2012
31/05/2013
DR. H. SUNARYO
PER/01/042012
01/04/2012
31/03/2013
ROSPITA SINAMBELAS
PER/01/052012
01/05/2012
30/04/2013
28881
PER/03/042012
01/04/2012
31/03/2013
0813-71129464 28991
DR ALIA LUBIS
PER/01/06/2012
01/06/2012
31/05/2013
5000
0852-65965655 28884
DR ROMADHIATI
PER/01/092012
01/09/2012
31/08/2013
10000
07970
0852-65221079 28953
DR SATRIA CANDRA
PER/04/062012
01/06/2012
31/05/2013
5000
10
06799
0819-28441919 28751
DR WAHYUDI
PER/16/092011
01/09/2011
31/08/2012
10000
11
07969
0812-7685917 28753
DR WILLIAM EDDY
PER/01/02/2012
01/02/2012
31/01/2013
5000
12
06967
PRAKTEK DR H SYAIFUL
JL BUDI KEMULIAAN 92 B
28881
DR H SYAIFUL
PER/17/122011
01/12/2011
30/11/2012
10000
13
06966
PRAKTEK DR HJ NUKE HS
28881
DR HJ NUKE HS
PER/01/122012
01/06/2012
31/12/2013
10000
14
04679
28881
15
00345
RSUD DUMAI
0765-38367
28884
PEMKO DUMAI
16
04607
-0765-38367
28882
PEMKO DUMAI
17
04521
0765-31924
28885
H. A. GAFAR
18
04142
0765-32004
28881
HERIFNEL
07447
JL MERDEKA NO 8
0765-439026
28881
DR RAHMI SALBI
04520
BP AMANAH
0812-7598583 28884
07461
BP MUTIARA KASIH
0813-78691688 28881
IR BORJU SIHOMBING
00344
BP. SEHATI
JL. SUKAJADI NO 83
0765-34584
28882
07302
KLINIK AGUNG
0812-75445577 28953
00338
JL S S KASIM DUMAI
0765-31091
07971
06798
RI244010
5000
10000
v
v
10000
10000
70
PER/01/032012
01/03/2012
28/02/2013
7000
PER/02/032012
01/03/2012
28/02/2013
14000
PER/01/042012
01/04/2012
31/03/2013
14000
PER/03/062012
01/06/2012
31/05/2013
10000
PKR102001
Halaman :
Tanggal :
42/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
08081
29351
DR RUDI ARDIAN
04755
PUSKESMAS K. CENAKU
29352
07922
0812-75669274 29352
02943
PUSKESMAS SAPAT
29254
07630
PUSKESMAS SEBERIDA
29312
06836
0813-65730593 29252
00357
BIDAN ROHAIDA
08096
BP"KHAIRUN NISA"
06995
10
RS
APT
v
v
HARI BUKA
PPK II
OPT LAB PEM ABRI BUMN SWASTA
NO IKS
SENIN, SELASA, RABU, GIGI (SHIFT 1,SHIFT 3,SHIFT PER/12/102012
KAMIS, JUM'AT,
6,SHIFT 5,SHIFT 2,SHIFT 4)
SABTU
POLA PEMBIAYAAN
JAM BUKA
AWAL IKS AKHIR IKS KAPITASI FFS REIMBURSE
01/01/2013
31/12/2013
2500
10000
JUMLAH
TTG
PER/26/122012
01/01/2013
31/12/2013
5000
7000
PER/01/012009
01/01/2009
31/12/2009
PUSKESMAS SEBERIDA
PER/19/122012
01/01/2013
31/12/2013
7000
SRI SUGIARTI
PER/18/122012
01/01/2013
31/12/2013
1000
0812-75473847 29352
BIDAN ROHAIDA
PER/02/012011
01/01/2011
31/12/2011
7000
JL POROS-TITIAN RESAK
08127-579648 29312
PER/14/10-2012
01/11/2012
30/04/2013
1500
0812-76091106 29352
JUNI MESRIANA P
PER/20/122012
01/01/2013
31/12/2013
08095
DR ALFAJAR HARAHAP
29312
DR ALFAJAR HARAHAP
PER/13/102012
01/11/2012
30/04/2013
11
04696
DR DJASMUDDIN DJALAL
0812-7517848 29352
DR DJASMUDDIN DJALAL
PER/25/122012
01/01/2013
31/12/2013
14000
12
04695
DR USFA NILAWATI
0813-65644714 29352
DR USFA NILAWATI
PER/22/122012
01/01/2013
31/12/2013
7000
13
03995
DR. MARDIANA
0812-75313220 29355
DR. MARDIANA
PER/28/122012
01/01/2013
31/12/2013
14
03969
0812-7665412 29254
RISNA HIDAYATI
PER/23/122012
01/01/2013
31/12/2013
15
07602
0853-74919026 29312
PER/27/122012
01/01/2013
31/12/2013
16
06351
0812-6868186 29354
PER/24/122012
01/01/2013
31/12/2013
7000
17
07879
KLINIK "MUZIZAH"
-081376851776 29355
PER/21/122012
01/01/2013
31/12/2013
500
18
07810
-085297261086 29363
DR.TOMI PRATAMA
PER/01/032012
01/04/2012
31/12/2012
10000
19
06728
29312
PER/16A/072011
01/01/2012
31/12/2012
14500
20
06766
29361
PER/02/032012
01/04/2012
31/12/2012
50000
RI244010
v
v
3000
v
v
1500
7000
7000
v
v
7000
PKR102001
Halaman :
Tanggal :
43/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/16/122012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
KAMIS, JUM'AT,
GIGI (SHIFT 1), SALIN (SHIFT
SABTU, MINGG
1)
01/01/2013
31/12/2013
10000
PER/09/092012
01/10/2012
30/09/2013
10000
PER/14/122012
01/01/2013
31/12/2013
14000
PER/15/122012
01/01/2013
31/12/2013
10000
RUSTAM
PER/13/122012
01/01/2013
31/12/2013
7000
DR. LIHAYATI
PER / 06 / 042012
01/05/2012
30/04/2013
5000
28884
DR. LIHAYATI
PER/ 08 / 062012
01/07/2012
30/06/2013
5000
0765-7038098 28884
HARIANSYAH
PER/10/092012
01/10/2012
30/09/2013
5000
RB AULIA YASMIN
0765-91611
28884
PER/02/022012
01/03/2012
28/02/2013
1000
07034
28751
HARIANSYAH
PER/17/122012
01/01/2013
31/12/2013
10000
11
07120
RB NUSANTARA
0765-594754
28751
ALFRAYETTI SST
PER/03/022012
01/03/2012
28/02/2013
1000
12
07121
28751
13
04401
RS PERMATA HATI
28751
14
0765-560378
28884
FITRI HALIM
15
04402
28884
FITRI
06560
BP DIAN HUSADA
0765-92404
28751
HARIANSYAH
07033
BP DURI MEDIKA
0765-7038098 28884
HARIANSYAH
02984
-0765-598085 28751
06078
28884
04400
BP SEJAHTERA
28884
07834
28953
07950
07529
RB "DURI MEDIKA"
07119
10
RI244010
OPTIK PRESIDENT
PER/04/022012
01/03/2012
28/02/2013
5000
PER/18/122012
01/01/2013
31/12/2013
9000
PER/12/122012
01/01/2013
31/12/2013
5000
PER/11/112012
01/12/2012
31/12/2013
7000
PKR102001
Halaman :
Tanggal :
44/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
07935
0819-59083500 28371
DR NURSIAH LUBIS
07919
BP ELLIYA HUSADA
0813-78173462 28381
HJ. ELLIYANNORA
07796
07735
0813-78746529 28381
07479
-081378898243 28454
07933
06839
KLINIK SANSANI
07734
07934
RI244010
HARI BUKA
PPK II
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/11/062012
01/06/2012
31/05/2013
PER/09/052012
01/06/2012
31/05/2013
PER/03/022012
01/03/2012
28/02/2013
5000
DR FETRI LUSIANA
PER/01/012012
01/03/2012
28/02/2013
5000
PER/15/072012
01/08/2012
31/07/2013
5000
0813-65585905 28454
PER/13/062012
01/06/2012
31/05/2013
5000
0761-564564
28381
SYAHRONI TUA
PER/18/102012
01/10/2012
31/12/2013
3000
0852-71554239 28371
DR ELI SUSANTI
01/01/2013
31/12/2013
5000
0852-63863511 28371
01/07/2012
30/06/2013
5000
PER/12/062012
5000
PKR102001
Halaman :
Tanggal :
45/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/12/032012
01/04/2012
31/03/2013
7000
SENIN
PER/09/012012
01/02/2012
31/01/2013
12000
PER/39/112012
01/12/2012
31/12/2013
7000
DZULKARNAIN
PER/47/122012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
GIGI (SHIFT 1), SALIN (SHIFT
KAMIS, JUM'AT,
1)
SABTU, MINGG
01/01/2013
31/12/2013
7000
0778-361959
PER/42/122012
SENIN, SELASA, RABU, UMUM (SHIFT I,SHIFT II),
GIGI (SHIFT I), SALIN (SHIFT
KAMIS, JUM'AT,
I)
SABTU, MINGG
01/01/2013
31/12/2013
14000
29431
0778-371261
PER/44/122012
01/01/2013
31/12/2013
11000
0778-3581097 29431
0778-371261
PER/45/122012
01/01/2013
31/12/2013
7000
BP VELY
0778-9131737 29411
PER/24/072012
01/07/2012
30/06/2013
9000
06336
0778-7822700 29411
0778-361959
TUMBUR M SIHALOHO
PER/46/122012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
GIGI (SHIFT 2), SALIN (SHIFT
KAMIS, JUM'AT,
1)
SABTU, MINGG
01/01/2013
31/12/2013
7000
10
06607
0777-325100
29623
YUSRIANA SUSANTI
PER/13/0312
01/04/2012
31/03/2013
7000
11
06256
0778-391498
29457
0778-391498
PER/49/122012
01/01/2013
31/12/2013
21000
12
06445
0779-21329
29623
PER/40/112012
01/12/2012
31/12/2013
7000
13
06257
RSUD KAB.KARIMUN
0777-327808
29611
0777-327818
PER/07/012012
01/02/2012
31/01/2013
7000
14
06478
RS.BAKTI TIMAH
0777-31685
29662
0777-31685
PER/41/122011
01/01/2012
31/12/2012
7000
15
08108
0778-332002
29438
0778-362089
FRIYANDRA
01/11/2012
31/12/2013
16
06556
0778-322121
29411
PER/40/122011
01/01/2012
31/12/2012
7000
17
06477
0777-326283
29662
PER/42/122011
01/01/2012
31/12/2012
7000
18
06258
0777-327808
29611
0777-327818
PER/08/012012
01/02/2012
31/01/2013
7000
19
06684
0777-7367176 29623
PER/031/102012
01/06/2012
31/05/2013
7000
20
06605
JL.DR.CIPTOMANGUNKUSUMO SEKUPANG
0778-325121
DR.SRINRAFELA ALLAIDA
PER/01/012011
01/01/2011
31/12/2011
7000
21
06317
OPTIK VISION
JL. A. YANI SUNGAI LAKAM NO.09 TANJUNG BALAI KARIMUN 0777-7008768 29662
0777-23344
HARTONO
PER/30/092012
01/09/2012
31/08/2013
22
29411
PER/34/102012
01/11/2012
31/10/2013
23
0778-431777
29411
0778-432777
PER/18/062012
01/06/2012
31/05/2013
7000
24
29411
PER/15/042012
01/04/2012
31/03/2013
7000
06606
0777-361722
29623
DR DEDDY
06518
0777-21060
29623
06445
0779-21329
29662
DRG SOERJADI
07437
0778-322259
29411
07001
0778-361958
29431
06999
0778-395142
07000
07415
RI244010
29411
v
v
PKR102001
Halaman :
Tanggal :
46/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
06405
PKM KEBON IX
36361
03173
36361
07401
PKM MARKANDING
03637
PKM MERLUNG
06890
00398
PKM. KEBON IX
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER / 54 / 102012
01/11/2012
31/10/2013
500
3000
01/04/2012
31/03/2013
36382
PER / 35 / 042012
07/06/2012
06/06/2013
36552
01/04/2012
31/03/2013
36555
PER / 84 / 092010
01/09/2010
31/08/2011
PKM MERSAM
36653
01/04/2012
31/03/2013
1000
00395
36653
01/04/2012
31/03/2013
500
07989
36361
PER / 39 / 052012
30/06/2012
31/05/2013
2000
00394
36121
PER / 22 / 042012
01/05/2012
30/04/2013
10000
10
07499
0812-7316611 36382
PER / 44 / 072012
08/08/2012
07/08/2013
1000
11
07877
PKM PUDING
36371
PKM PUDING
PER / 17 / 042012
01/05/2012
30/04/2013
1000
12
07788
PKM PURWODADI
36552
PIMPINAN PKM
PER / 59 / 122011
01/01/2012
31/12/2012
13
04343
36573
01/03/2012
28/02/2013
5000
14
00393
36121
01/04/2012
31/03/2013
1000
15
00396
36121
PER / 24 / 042012
01/05/2012
30/04/2013
1000
16
07990
PKM TEMPINO
36371
PER / 38 / 052012
01/07/2012
30/06/2013
2000
17
00404
36121
PER / 23 / 042012
01/05/2012
30/04/2013
10000
18
04073
36121
19
06613
DR A SURYA D GINTING
36553
DR A SURYA D GINTING
01/03/2012
28/02/2013
1000
20
06117
DR AGUS SUBEKTI
36361
DR AGUS SUBEKTI
01/03/2012
28/02/2013
2000
21
07789
DR ERIC PANGERAN
36121
DR ERIC P
PER / 61 / 012012
01/03/2012
28/02/2013
1000
22
04434
DR GESHAN SUMAMARTA
36655
DR GESHAN SIMARMATA
01/04/2012
30/03/2013
3000
23
07994
DR H MAULANA MKM
36121
DR H MAULANA MKM
PER / 40 / 052012
01/08/2012
31/07/2013
2000
24
07400
DR IRWAN NURHAKIM
0813-66474220 36382
DR IRWAN NURHAKIM
PER / 28 / 062011
07/06/2011
06/06/2012
RI244010
PKM TEMPINO
500
10000
v
v
50
1000
29000
300
PKR102001
Halaman :
Tanggal :
47/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
25
06175
DR NANI
36382
DR NANI
26
06174
KOMP PKM PIJOAN BARU DESA TEBING TINGGI TANJABBAR 0812-7415466 36552
DR PUTRI ANDAYANI S
27
07399
DR RINALDY SINAGA
36653
28
07723
36361
29
03885
36121
30
03893
KLINIK SEMBUBUK
0741-61918
36653
0741-62737
31
07160
36552
32
06346
0741-670459
36121
33
00405
0741-61692
36121
34
03701
35
07403
RS ISLAM ARAFAH
36
07402
RS KAMBANG
37
07991
38
HARI BUKA
PPK II
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER / 33 / 042012
01/04/2012
31/03/2013
PER / 20 / 042012
01/05/2012
30/04/2013
DR RINALDY SINAGA
PER / 34 /042012
01/06/2012
31/05/2013
DR SISKA DEWI B
PER / 60 / 012012
01/03/2012
28/02/2013
5000
PER / 21 / 042012
01/05/2012
30/04/2013
25000
01/04/2012
31/03/2013
20000
PER / 36 / 042012
01/06/2012
31/05/2013
PER / 25 / 042012
01/05/2012
30/04/2013
25000
0741-60014
PER / 26 / 04212
01/04/2012
31/03/2013
25000
36653
PER / 62 / 012012
01/01/2012
31/12/2012
29000
0741-667966
36121
0741-63444
DR DIAN FITRI
PER / 27 / 042012
01/05/2012
30/04/2013
25000
0741-61714
36121
0741-61714
PER / 28 / 042012
01/05/2012
30/04/2013
10000
0741-671222
36121
0741-61468
PER / 18 / 042012
01/05/2012
30/04/2013
10000
07992
0741-445226
36112
0741-444155
DR MAULANA MKM
PER / 19 / 042012
01/05/2012
30/04/2013
15000
39
02948
0741-65765
36121
PER / 29 / 042012
01/04/2012
31/03/2013
25000
40
07162
36121
KOMSATUN
PER / 30 / 062011
01/04/2011
31/03/2012
41
07993
36121
PER / 37 / 052012
01/06/2012
31/05/2013
42
07161
36552
PER / 48 / 092012
01/06/2012
31/05/2013
43
03700
OPTIK CITRA
JL M HUSNI THAMRIN NO 61 A
36121
H FERISYAL RAMLI
PER / 42 / 072012
01/08/2012
31/07/2013
10000
44
04641
OPTIK MITRA
36121
DEDI SIRIN
PER / 47 / 092012
01/08/2012
31/07/2013
7000
45
02947
36121
SYAIFUL HARIFIN
PER / 43 / 072012
01/08/2012
31/07/2013
10000
46
04105
OPTIK TIARA
36121
IRWAN NURMATIAS
PER / 45 / 072012
01/08/2012
31/07/2013
10000
47
04640
OPTIK UTAMA
36121
DARPINAS ALI
PER / 51 / 102012
01/08/2012
31/07/2013
10000
48
06345
OPTIK ZAL
0812-7234741 36121
ADLI
PER / 53 / 102012
01/09/2012
31/08/2013
10000
49
0700000000017 RS DR BRATANATA
JL RD MATTAHER NO 33
0741-20388
36121
PER / 16 / 042012
01/04/2012
31/03/2013
50
36653
PER/474.4/7834/RSUD /
2007
01/07/2007
30/06/2008
51
0741-667966
36111
0741-667966
PER / 41 / 072012
01/08/2012
31/07/2013
RI244010
v
v
RS ISLAM ARAFAH
2500
v
v
600
5000
PKR102001
Halaman :
Tanggal :
48/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
07546
-0811743927
37559
06148
PUSKESMAS BABEKO
37253
08064
PUSKESMAS MANDIANGIN
-081366159505 37391
05370
JALAN KESUMA NO 2
07141
JL DIPONEGORO NO 1
05389
06084
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/ 17 / 102012
01/10/2012
31/12/2013
7000
PER/10/052012
01/05/2012
30/04/2013
7000
PER / 18 / 102012
01/10/2012
31/12/2013
7000
37253
DINAS KESEHATAN
PER/01/012013
01/01/2013
31/12/2013
7000
0744-21039
37571
PER/03/022012
01/02/2012
31/01/2013
7000
DS RANTAU IKIL
37255
PUSKESMAS
PER/02/022012
01/02/2012
31/01/2013
7000
37253
PEMDA
PER / 06 / 032012
01/03/2012
28/02/2013
7000
07702
-081274896100 37372
DR YULI MURYANI
PER/16/082012
01/08/2012
31/07/2013
1500
07771
KLINIK DR SILVANA
-081363086654 37253
DR SILVANA
PER/09/032012
01/03/2012
28/02/2013
7000
10
06918
0747-7326141 37254
NURDAINI
PER/19/112012
01/11/2012
31/12/2013
11
07314
37271
A EFENDI HARAHAP
PER/11/052012
01/05/2012
30/04/2013
7000
12
07324
37311
DR H SYAHRIAL M
PER/15/062012
01/06/2012
31/05/2013
7000
13
06561
SAFARUDDIN MATONDANG
37253
DR SAFARUDDIN MATONDANG
PER / 07 / 032012
01/03/2012
28/02/2013
7000
14
07705
JL KESEHATAN NO 20 BANGKO
0746-21459
37311
PEMKAB MERANGIN
PER/13/052012
01/05/2012
31/05/2013
15
06128
RSUD H HANAFIE
MUARO BUNGO
37253
PER / 08 / 032012
01/03/2012
28/02/2013
16
07703
JL LINTAS SUMATERA
37353
PER/12/052012
01/05/2012
31/05/2013
17
06129
MUARO BUNGO
37253
PER / 08 /032012
01/03/2012
28/02/2013
18
07704
37353
PER/12/052012
01/05/2012
31/05/2013
19
07706
APOTEK HUSADA
JL KESEHATAN NO 20 BANGKO
0746-21459
37311
PER/14/052012
01/06/2012
31/05/2013
20
05524
OPTIK CITRA
0747-22134
37255
PER/09/052012
01/05/2012
30/04/2013
RI244010
PEMERINTAH DAERAH
v
v
7000
2500
2500
PKR102001
Halaman :
Tanggal :
49/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/22/042012
01/04/2012
31/03/2013
10000
PER/02/012013
01/01/2013
31/12/2013
7000
PER/23/042012
01/04/2012
31/03/2013
7000
DR DESTI
PER/24/042012
01/04/2012
31/03/2013
10000
DR HJ YULIA DARLINA
PER/25/042012
01/04/2012
31/03/2013
5000
PER/26/042012
01/04/2012
31/03/2013
10000
DR ANTON SUWINDRO
PER/38/042012
01/04/2012
31/03/2013
8000
PER/63/082012
01/08/2012
31/07/2013
5000
30126
NURJANAH SKM
PER/64/092012
01/09/2012
31/08/2013
5000
30126
PER/62/072012
01/07/2012
30/06/2013
2000
30112
BIDAN EMMAWATI
PER/49/052012
01/05/2012
30/04/2013
6000
BP. SUKARAME
30112
PER/12/032012
01/03/2012
28/02/2013
5000
07594
DOKTER MERIANCE
30752
PER/72/122012
01/12/2012
30/11/2013
5000
14
07803
30752
PER/15/042012
02/04/2012
31/03/2013
15
07213
30126
PER/37/042012
01/04/2012
31/03/2013
7000
16
07131
30112
PER/07/022012
01/02/2012
31/01/2013
2000
17
07949
30127
DR YUNIAR SARI
PER/57/062012
01/05/2012
30/04/2013
1000
18
03670
DR ACHMAD AZHARI
30128
DR A AZHARI
PER/29/042012`
01/04/2012
31/03/2013
10000
19
00411
DR JHON GANEFI
30128
DR JHON GANEFI
PER/30/042012
01/04/2012
31/03/2013
14000
20
07258
DR SUHERMAN
30112
PER/34/042012
01/04/2012
31/03/2013
5000
21
03671
DR WAHYUDI
30127
DR WAHYUDI
PER/18/042012
01/04/2012
31/03/2013
14000
22
06373
DR. CHRISTANTONO B P
0733-321966
38653
PER/50/052012
01/05/2012
30/04/2013
5000
23
06472
-081367614585 30112
PER/06/022012
01/02/2012
31/01/2013
5000
24
06013
DR. FAUZIAH
DR. FAUZIAH
PER/33/042012
01/04/2012
31/03/2013
7000
00430
PUSKESMAS 4 ULU
30128
05982
PUSKESMAS GANDUS
30112
03673
PUSKESMAS KAMPUS
JL GOLF NO 05 PALEMBANG
30128
00410
PUSKESMAS MERDEKA
30128
03674
PUSKESMAS PAKJO
30128
00429
PUSKESMAS PLAJU
30128
03675
PUSKESMAS SEKIP
30128
08005
BP RIZKY ASYIFA
30164
08031
BP SAKO
JL. TULANG BAWANG IV NO 2364 RT 034 RW 009 KEL LEBUNG GAJAH KEC SAKO
10
07965
BP UMUM AZ ZAHRA
11
04974
BP. MARISA
12
04843
13
RI244010
30112
5000
PKR102001
Halaman :
Tanggal :
50/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/32/042012
01/04/2012
31/03/2013
5000
PER/11/032012
01/03/2012
28/02/2013
5000
DR NELLY NAJIB
PER/01/012013
01/01/2013
31/12/2013
7000
PER/56/062012
01/06/2012
31/05/2013
5000
-08127858135 30752
DR. ZALMAIDAR
PER/70/122012
01/12/2012
30/11/2013
5000
30164
PER/54/062012
01/06/2012
31/05/2013
5000
JL SOSIAL KM 5 PALEMBANG
30128
PER/31/042012
01/04/2012
31/03/2013
14000
07589
JL. GARUDA NO. 66 KEL LUBUK AMAN KEC. LUBUK LINGGAU BARAT I
31614
PER/58/112011
01/11/2011
30/10/2012
6000
33
04339
30128
PER/01/012012
01/01/2012
31/12/2012
10000
34
04511
30128
DRG MARJAN
PER/27/032012
01/04/2012
31/03/2013
10000
35
04844
30112
PER/58/032012
01/04/2012
31/03/2013
5000
36
00406
30128
PER/19/042012
01/04/2012
31/03/2013
37
02950
KLINIK ALBAR
30129
DR JHONNY DHOLET
PER/35/042012
01/04/2012
31/03/2013
10000
38
04977
30112
BIDAN TJIK YA
PER/51/052012
01/06/2012
30/04/2013
5000
39
04978
30112
PER/13/032009
01/03/2009
28/02/2010
300
40
08069
30652
PER/67/102012
01/10/2012
30/09/2013
5000
41
05309
0711-315961
30128
DR ERDAYANA FATMA
PER/68/102012
01/10/2012
30/09/2013
7000
42
08070
KLINIK OPINA
30126
DR H TRISNAWARMAN
PER/66/102012
01/10/2012
30/09/2013
5000
43
00413
30128
PER/36/042012
01/04/2012
31/03/2013
7000
44
00414
30128
DR. NURSYIRWAN
PER/40/042012
01/04/2012
31/03/2013
14000
45
00409
POLIKLINIK AL-ITTIHAD
30128
PER/28/042012
01/04/2012
31/03/2013
10000
46
03962
RB ASRI
30128
BDN HJ ASMAWATI
PER/39/042012
01/04/2012
31/03/2013
10000
47
03963
RB SAYANG BUNDA
30128
PER/29/042011
01/04/2011
30/03/2012
7000
48
04722
RB. MARISA
30112
PER/250/082010
01/08/2010
31/07/2011
2000
25
06337
DR. INTAN
30752
DR. INTAN
26
06064
30112
27
04425
30128
28
06170
0711-
30112
29
06403
DR. ZALMAIDAR
30
07334
31
03677
32
RI244010
20000
PKR102001
Halaman :
Tanggal :
51/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/69/102012
01/10/2012
30/09/2013
5000
PER/08/022009
01/02/2009
31/01/2010
20000
49
05311
30128
ELLY FAUZIAH
50
05664
30123
DR YOSI MINAWATI
51
03678
PPK1-RSUD SEKAYU
7000
52
03964
RB DHARMA WIDYA
KENTEN PALEMBANG
7000
53
04322
RS SIMPATI MEDIKA
7000
54
03734
RS AKAGANI
JL MERDEKA
30128
55
00423
RS PELABUHAN
0711-711843
30128
DR H M SYAIFUL HUDA
56
04323
RSUD SEKAYU
30128
57
03733
JL JEND SUDIRMAN KM 3
30128
58
00421
RSU MUHAMMADIYAH
30128
59
04845
OPTIK VISION
30112
60
06544
APOTIK HESTI
0711-354691
30112
61
04097
APOTIK OGAN
0711-351401
30127
0711-355148
ENNY
62
04319
OPTIK GARUDA
-355909
30128
63
04320
OPTIK INTERNASIONAL
30128
64
07884
OPTIK LASER
0812-73650199 30112
65
03967
OPTIK MITRA
0711-312270
66
03735
OPTIK SEIS
67
07958
68
00427
69
70
PER/65/092012
01/09/2012
31/08/2013
7000
PER/15/042012
01/04/2012
31/03/2013
7000
PER/17/042012
01/04/2012
31/03/2013
7000
PER/51/082011
01/08/2011
31/07/2012
7000
PER/16/042012
01/04/2012
31/03/2013
7000
v
v
70
PER/13/032012
01/03/2012
28/02/2013
7000
PER/75/012013
01/01/2013
31/12/2013
7000
PER/59/012009
01/01/2009
31/12/2009
7000
LINGGAR YANTO
PER/55/062012
01/06/2012
31/05/2013
7000
AGUSTRIMAN
PER/48/052012
01/05/2012
30/04/2013
1000
30127
IWAN
PER/05/012012
01/01/2012
31/12/2012
7000
30128
ABOE
PER/21/042012
01/04/2012
31/03/2013
7000
0711-820145
30126
LITWAN RAIS RO
PER/61/072012
01/07/2012
30/06/2013
5000
OPTIK SURYA
30128
SURYADI LAIS OD
PER/41/042012
01/04/2012
31/03/2013
7000
07948
OPTIK SURYA 3
1326
SURYAWINATA LAIS
PER/58/062012
01/06/2012
31/05/2013
500
03966
OPTIK OPI
JL JEND SUDIRMAN NO 10
RI244010
7000
PKR102001
Halaman :
Tanggal :
52/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/04/012013
01/01/2013
31/12/2013
7000
PER/23/072012
01/07/2012
30/06/2013
7000
PER/01/012013
01/01/2013
31/12/2013
7500
PER/13/042012
01/04/2012
31/03/2013
7000
PER/11/042012
01/04/2012
31/03/2013
7000
DR.WILSON MARPAUNG
PER/31/11/2012
01/11/2012
31/10/2013
7000
PER/09/042012
01/04/2012
31/03/2013
7000
38361
PER/08/042012
01/04/2012
31/03/2013
7000
38361
ROSMAWATI PURBA
PER/15/052012
01/05/2012
30/04/2013
7000
38361
PER/05/012013
01/01/2013
31/12/2013
10000
38118
PER/31/122012
01/12/2012
30/11/2013
7500
0736-346719
38361
PER/25/092012
01/09/2012
31/08/2013
7000
38361
PER/32/122012
01/12/2012
30/11/2013
7500
06655
KLINIK DR MARIA AGNES LIESYE ELIZABETH JL.RAYA CURUP BENGKULU KM.14 KEMBANG SERI
-081539284928 38653
PER/34/122012
01/12/2012
30/11/2013
7000
15
07487
38572
DR YULI HARMI
PER/26/092012
01/09/2012
28/02/2013
7000
16
06657
-081328739182 38361
PER/18/062012
01/06/2012
31/05/2013
7000
17
07223
38656
PER/12/042012
01/04/2012
31/03/2013
7000
18
05873
38227
PER/27/092012
01/09/2012
31/08/2013
7000
19
05871
39116
PER/10/042012
01/04/2012
31/03/2013
7000
20
05418
38361
DR. M.IRSAN
PER/03/012013
01/01/2013
31/12/2013
7000
21
07980
39118
DOKTER ISWADI
PER/22/072012
01/07/2012
30/06/2013
7000
22
08007
38555
PER/24/082012
01/08/2012
31/07/2013
23
08062
38386
PER/29/102012
01/10/2012
30/09/2013
24
05423
38363
PER/16/052012
01/04/2012
31/03/2013
02964
PKM IPUH
38572
PKM IPUH
07981
38572
08146
38765
07841
PUSKESMAS PENARIK
6285368475454
38572
06656
38655
04232
38572
05420
PUSKESMAS TES
39162
05419
05872
10
02961
BP ANUGRAH (KLINIK DR.NETTY HERAWATY) JL SALAK NO 102 PANORAMA BENGKULU/ JL KAPUAS RAYA 0736-24887
NO 82
11
08116
12
07486
BP MEDISTRA
13
08115
14
RI244010
PUSKESMAS PENARIK
7000
7000
v
v
PKR102001
Halaman :
Tanggal :
53/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/05/012012
01/01/2012
31/12/2012
7000
PERJAN/05/012009
01/01/2009
31/12/2009
7000
PER/06/012012
01/01/2012
31/12/2012
7000
PER/04/012011
01/01/2012
31/12/2012
7000
PER/20/062012
01/04/2012
31/03/2013
25
05421
38572
26
05422
38572
27
00431
0736-52004
38361
28
02965
APOTIK KURNIA
JL BHAYANGKARA NO 43 BENGKULU
0736-52066
38361
HJ. RATNAWATI
29
05424
OPTIK KORNEA
38364
IKA SARI. LO RO
RI244010
HARI BUKA
PPK II
v
v
PKR102001
Halaman :
Tanggal :
54/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/031/092012
01/09/2012
31/08/2013
7000
PER/031/092012
01/09/2012
31/08/2013
7000
PER/031/092012
01/09/2012
31/08/2013
7000
PER/033/092012
01/09/2012
31/08/2013
7000
33365
PER/031/092012
01/09/2012
31/08/2013
7000
-0715-351125 33365
PER/031/092012
01/09/2012
31/08/2013
7000
-0719-25556
33461
PER/040/112012
01/11/2012
31/12/2013
7000
07940
PUSKESMAS BAKAM
PER/018/072012
01/07/2012
30/06/2013
7000
06028
33253
PER/004/022012
01/02/2012
31/01/2013
7000
10
00453
PUSKESMAS BELINYU
-0715321173
33253
PER/034/102012
01/10/2012
31/08/2013
7000
11
00452
PUSKESMAS PEMALI
PEMALI - BANGKA
33252
PER/033/092012
01/09/2012
31/08/2013
7000
12
02967
PUSKESMAS PERAWAS
-08127881565 33452
PER/040/112012
01/11/2012
31/12/2013
7000
13
00445
-0719-21074
33452
PER/040/112012
01/11/2012
31/12/2013
7000
14
00444
PUSKESMAS TOBOALI
0853-57219180 32431
PER/032/092012
01/09/2012
31/08/2013
7000
15
07057
DR HENDRI SUSANTO
0813-67993449 33362
DR HENDRI SUSANTO
PER/005/022012
01/02/2012
31/01/2013
7000
16
07605
DR HERINDRATI
JALAN SIJUK RT 018 RW 006 KELURAHAN DESA AIR MERBAU KEC TANJUNGPANDAN KAB BELITUNG
33452
DR HERINDRATI
PER/042/122012
01/12/2012
31/12/2013
7000
17
07056
DR MUHAMAD FAUZAN
0813-87111207 33252
DR MUHAMAD FAUZAN
PER/006/022012
01/02/2012
31/01/2013
7000
18
05634
DR SJENILEILA BOER
0811-7174480 33171
DR SJENILEILA BOER
PER/023/072012
01/07/2012
30/06/2013
7000
19
07147
DR VONNY PRIMASARI
0819-29749703 33252
DR VONNY PRIMASARI
PER/014/032011
01/03/2011
28/02/2012
20
06265
0812-71553465 33253
DR BAHRUN SS
PER/028/082012
01/08/2012
31/07/2013
7000
21
06756
33252
PER/027/082011
01/08/2012
31/07/2013
7000
22
05977
0812-7176488 33171
PER/01/012013
01/01/2013
31/12/2013
20000
23
07058
DRG MARTARIWANSYAH
0813-20016844 33362
DRG MARTARIWANSYAH
PER/007/022012
01/02/2012
31/01/2013
7000
24
07536
0812-7804834 33252
PER/035/102012
01/10/2012
30/09/2013
7000
05859
PKM KELAPA
DS KELAPA
33364
00455
PKM MENTOK
-0716-351125 33362
05857
DS SIMPANG TERITIP
33366
00451
PKM SUNGAILIAT
-0717-94440
33252
05858
PKM TEMPILANG
DS TEMPILANG
00454
00446
RI244010
7000
PKR102001
Halaman :
Tanggal :
55/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/029/082012
01/08/2012
31/07/2013
7000
PER/008/022012
01/02/2012
31/01/2013
7000
PER/009/022012
01/02/2012
31/01/2013
PER/041/112012
01/11/2012
31/12/2013
7000
PER/010/022012
01/02/2012
31/01/2013
14000
25
06267
33252
26
07110
0819-29694905 33452
27
07112
0812-9944259 33462
28
07565
HENDRY JAN
29
06450
SUN CLINIC
0717-4297888 33252
0717-439488
30
03137
PUSKESMAS MENTOK
-0716-21362
33362
31
00437
RSU SUNGAILIAT
0717-92489
33252
0717-92534
32
00438
RSU TJ PANDAN
0719-21071
33452
33
06268
0719-91738
34
06266
JL BY PASS KOBA
35
03135
36
05190
37
33171
HARI BUKA
PPK II
7000
PER/070/082007
10/08/2007
09/08/2008
7000
PER/050/072012
01/07/2012
31/12/2013
7000
0719-22190,
21071
PEMDA
PER/021/052012
01/05/2012
30/04/2013
7000
33462
0719-91738
PEMDA BELTIM
PER/056/082010
01/08/2010
31/07/2011
7000
33253
PER/038/082012
01/08/2012
31/12/2013
7000
0717-42489
33171
PER/049/072012
01/07/2012
31/12/2013
7000
0716-21111
33362
0716-21111
PER/013/022012
01/02/2012
31/01/2013
05191
RS MEDIKA STANIA
0717-95837
33253
0717-93335
38
04707
0717-422605
33171
0717-422605
39
06672
0717-4297815 33252
40
00439
APOTIK PELENGKAP KF
-0717-423012 33171
41
33171
42
06673
APOTEK ALMAH
0717-4297816 33252
PT KENANGA SEJAHTERA
43
07111
APOTEK AURA
33462
44
07894
APOTEK BUDI
0719-21580
33452
45
05189
JL KADUR DALAM
33362
46
03136
APOTIK BENUA
JL S PARMAN SUNGAILIAT
-0717-92125
47
00440
-0719-23660
48
03812
APOTEK MANGNGAMASEANG
-071925230
49
03811
OPTIK AKUR
-0717438048
33171
PER/17/092008
01/09/2008
31/08/2009
7000
50
00441
OPTIK BUDI
33173
PER/037/082012
01/08/2012
31/12/2013
7000
51
07528
OPTIK INTERNASIONAL
0717-438646
33171
PER/051/112012
01/11/2012
31/12/2013
52
07566
0717-436324
33171
EDIYANSYAH, A . MD
PER/042/112011
01/12/2012
31/12/2012
RI244010
PER/012/022012
01/02/2012
31/01/2013
7000
YAYASAN
PER/030/072012
01/07/2012
30/06/2013
7000
PT KENANGA SEJAHTERA
PER/052/062012
01/06/2012
31/05/2013
10000
PER/039/092012
01/09/2012
31/12/2013
7000
PER/20/092008
02/09/2008
01/09/2009
PER/049/062011
01/06/2011
31/05/2012
PER/011/022011
01/02/2011
31/01/2012
PER/026/082011
01/08/2011
31/07/2012
PER/015/032011
01/03/2011
28/02/2012
33252
PER/074/092010
01/09/2010
31/08/2011
7000
33452
PER/068/122007
03/12/2007
02/12/2008
7000
10000
7000
PKR102001
Halaman :
Tanggal :
56/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
04514
31356
07700
PUSKESMAS BERINGIN
KECAMATAN BERINGIN
0813-67397996 31213
07551
PUSKESMAS MERAPI II
0813-67175415 31471
03580
PUSKESMAS PENINJAUAN
31171
03708
-0713-390566 31173
06588
0813-67416328 31356
08131
JL. GARUDA NO.66 RT.02 KRLURAHAN LUBUK AMAN LUBUK 0853-83488999 31618
LINGGAU BARAT
02971
-08153803360 31352
06587
KLINIK DR RAHMANIAH
0812-8215262 31171
10
02970
-0734-453711 31315
11
05562
0735-325115
32155
12
07494
0813-67521076 31173
13
04024
KLINIK/RB. RANIZA
-0713-323404 30652
14
08082
31612
15
07115
16
07699
17
07495
18
SYAFRIZAL SKM
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/22/012012
01/01/2012
31/12/2012
7000
PER/29/012013
01/01/2013
31/12/2013
7000
PER/ 37/112012
01/11/2012
31/12/2013
10000
PER/23/012012
01/01/2012
31/12/2012
7000
PER/24/012013
01/01/2013
31/12/2013
7000
PER/19/012012
01/01/2012
31/12/2012
7000
7000
PER/37/112012
01/11/2012
31/12/2013
PER/21/012013
01/01/2013
31/12/2013
PER/18/012012
01/01/2012
31/12/2012
PER/20/012013
01/01/2013
31/12/2013
7000
PER/27/012012
01/01/2012
31/12/2012
7000
PER/34/092012
01/09/2012
31/12/2013
7000
DR. CHOIRUDIN
PER/26/012012
01/01/2012
31/12/2012
18000
PER/36/11/2012
01/11/2012
31/12/2013
7000
0852-68233004 32191
PER/28/012012
01/01/2012
31/12/2012
0852-68629789 31112
PER/30/012013
01/01/2013
31/12/2013
7000
PER/33/092012
01/09/2012
31/12/2013
7000
04519
PPK1-RSU BATURAJA
-0735-320298
19
06680
RS PERTAMINA PRABUMULIH
0713-382742
30662
20
02977
RSU BATURAJA
-0735-320298 31315
21
04515
-0731-321785 31452
22
07554
RSU DR SOBIRIN
0733-321013
31611
23
03483
24
05991
25
03557
26
v
DR. RAHMANIAH
v
v
7000
v
v
7000
7000
7000
PER/31/062012
01/06/2012
31/05/2013
10000
PER/13/012012
02/01/2012
31/12/2012
7000
PER/12/012012
02/01/2012
31/12/2012
7000
0733-324973
PER/30/022012
01/02/2012
31/01/2013
-0734-424345 31352
-0734422738
PER/11/012012
01/01/2012
31/12/2012
TALANG UBI
0813-67433792 31356
PER/14/012012
01/01/2012
31/12/2012
RS BUNDA
-0713-322954 30652
PER/15/012012
01/01/2012
31/12/2012
7000
06751
30665
PER/32/062011
01/06/2011
31/05/2012
10000
27
07555
0733-321013
31611
PER/31/022012
01/02/2012
31/01/2013
28
07218
0734-424345
31171
PER/30/042011
01/04/2011
31/12/2011
v
v
7000
15374
RI244010
PKR102001
Halaman :
Tanggal :
57/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
29
06014
APOTIK BHAYANGKARA
0713-7011987 31352
30
03578
-0713-320330 30652
31
02976
APOTIK KOKARSUM
32
04516
33
05992
APOTIK PATEN
34
04446
35
03579
36
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
31/12/2013
2000
PER/02/012013
PER/04/012012
01/01/2012
31/12/2012
7000
-0734-423455 31315
PER/03/012013
01/01/2013
31/12/2013
7000
31452
PER/01/012012
01/01/2012
31/12/2012
7000
31355
PER/06/012012
01/01/2012
31/12/2012
15000
-0735320463
32151
PER/05/012012
01/01/2012
31/12/2012
7000
-0713-382726
04902
OPTIK AGUNG
31171
ZAINURI
PER/08/012012
01/01/2012
31/12/2012
70
37
06499
0731-321110
31581
PER/09/012012
01/01/2012
31/12/2012
6000
38
04790
OPTIK COLUMBUS
31171
YOHANES YANTO
PER/07/012013
01/01/2013
31/12/2013
70
39
06572
USHY OPTIKAL
0734-451546
31172
SOPIAH
PER/10/012012
01/01/2012
31/12/2012
7000
RI244010
RAHMAT DIPURO ST
7000
PKR102001
Halaman :
Tanggal :
58/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/14/052012
01/05/2012
30/04/2013
7000
PER/53/102012
01/10/2012
30/09/2013
7000
PER/01/012012
01/01/2012
31/12/2012
7000
PER/44/092012
01/09/2012
31/08/2013
7000
PER/23/052007
01/04/2008
01/04/2009
PER/55/092012
01/10/2012
30/09/2013
7000
PER/01/012011
01/02/2011
31/01/2012
7000
PER/20/052012
01/04/2012
30/10/2012
7000
PER/02/012012
01/01/2012
31/12/2012
7000
DR RIA SARI
PER/25/052012
01/06/2012
30/05/2013
8000
PER/21/052012
01/06/2012
30/05/2013
7000
35361
DR.SRI RAHAYU
01/06/2012
30/05/2013
12510
35361
DR.NOVITA FITRIYATI
PER/29/052012
01/06/2012
30/05/2013
7000
PER/11/022012
01/03/2012
28/02/2013
7000
PER/24/052012
01/06/2012
30/05/2013
7000
PER/03/012012
01/01/2012
31/12/2012
7000
07272
-081321878171 35361
00467
PKM WATES
0725-7020963 35373
04113
PKM HANURA
-085269844739 35361
94982
PKM KEDATON
0721-702045
35377
04982
PKM KEDATON
35361
00460
35361
06516
0721-704016
35361
H. DALJONO,SH
07667
BP ARDHITO HUSADA
35361
06514
BP AZZAHRA
-081379224422 34152
10
00471
BP AZZURA
-081369371032 35361
11
00462
BP DARA PETAK
0721-7526948 35361
12
00465
BP DIRA MEDIKA
0721-263889
13
00463
BP IMAM BONJOL
0721-254169
14
07352
BP KELUARGA
0721-2592210 35361
0721-259335
15
00466
BP PANJANG MEDIKA
0721-7490825 35371
16
06515
BP PASAR TUGU
17
07962
18
00464
BP.ANDATU PT
19
06831
DR EMI SULISTIYANI
20
07961
DR LENI
21
06964
22
06617
23
24
PT KAI
DR TRISMI ISTIANA
DR.AILA KARYUS
7000
35362
35361
SUPRIYANTO
PER/37/072012
01/07/2012
30/06/2013
35361
DR.SRI RAHAYU
PER/30/052012
01/06/2012
30/05/2013
7000
-08127925721 34152
PER/21/062012
01/06/2012
30/05/2013
7000
35672
PER/17/062012
01/06/2012
30/11/2012
7000
35672
PER/55/112010
01/12/2010
30/11/2011
7000
DR MINDA NORA
-081390700033 35594
PER/09/022012
01/03/2012
28/02/2013
7000
07508
DR WIDYA ASTRIYANI
35361
PER/45/092012
01/09/2012
31/08/2013
7000
07100
DR YULI ROKHAYATI
35592
PER/07/012012
01/02/2012
31/01/2013
7000
RI244010
DR LENI
DR YULI ROKHAYATI
7000
PKR102001
Halaman :
Tanggal :
59/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
25
06513
DR. FEBRISWAN
-08127970011 34375
26
06552
27
06630
-081369567776 35373
28
08149
29
05447
DR. ULINNOHA
30
06322
31
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/06/012012
01/02/2012
31/01/2013
PER/12/042012
01/04/2012
31/03/2013
7000
PER/18/052012
01/05/2012
30/04/2013
7000
-08129412693 35353
PER/71/122012
01/01/2013
31/12/2013
0729-23381
35673
PER/56/102012
01/10/2012
30/09/2013
DRG ZAIRINA
-08137949553 35361
PER/19/052012
01/03/2012
28/02/2013
14000
05566
0721-771322
35362
PER/50/092012
01/09/2012
30/08/2013
17500
32
94951
0721-771758
35371
PER/31/052012
01/06/2012
30/05/2013
33
04951
35362
PER/16/062008
01/06/2008
01/06/2009
7010
34
07513
0721-253867
35371
PER/44/062012
01/03/2012
28/02/2013
7000
35
04528
0721-350145
35361
DR AGUS KELANA BK
PER/26/052012
01/06/2012
31/05/2013
7000
36
00459
0724-351054
35361
DRG. MERRY
PER/58/102012
01/10/2012
30/09/2013
7000
37
05564
RB KHARISMA
0721-31975
35361
CHRISTIN
PER/41/052012
01/06/2012
31/05/2013
38
03809
JL DR ARIVAI LAMPUNG
39
07581
35361
40
03702
0721-342087
35361
41
00472
0721-703312
35361
42
07099
0725-48423
34152
43
03767
RSUD KALIANDA
0727-322160
44
06548
RSUD SUKADANA
45
04950
46
07963
47
DR ULINNOHA
v
v
7000
7000
14000
15000
20000
PER/65/112012
01/11/2012
31/10/2013
14000
PER/62/082012
01/08/2012
31/07/2013
7000
PER/33/052012
01/04/2012
31/03/2013
20000
PER/12/042012
01/12/2011
30/11/2012
14000
35361
PER/63/082012
01/08/2012
31/07/2013
7000
0725-625022
34372
PER/05/022010
01/02/2010
31/01/2011
14000
35374
POLDA LAMPUNG
PER/20/062008
01/06/2008
01/06/2009
174
RS NATAR MEDIKA
0721-92521
35361
PER/22/062012
01/06/2012
31/05/2013
14000
02983
RS URIP SUMOHARJO
0721-771322
35361
PER/34/052012
01/06/2012
30/05/2013
7000
48
06854
RS WISMA RINI
0729-21096
35672
PER/52/2012
01/10/2012
30/09/2013
14000
49
05565
0721-704016
35362
H. DALJONO,SH
PER/48/062012
01/06/2012
31/05/2013
14000
50
08053
0721-484158
35361
0721-482432
PER/46/092012
01/09/2012
30/08/2013
7000
RI244010
PKR102001
Halaman :
Tanggal :
60/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
51
00474
0721-262991
35361
52
04624
OPTIK MODERN
0721-708444
35377
53
00477
OPTIK PEMUDA
0721-253944
35373
RI244010
RS
APT
v
SUKARYADI
HARI BUKA
PPK II
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/60/082012
01/08/2012
31/07/2013
7000
PER/51/092012
01/10/2012
30/09/2013
174
PER/54/102012
01/10/2012
30/09/2013
7000
PKR102001
Halaman :
Tanggal :
61/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
04469
PKS DAYAMURNI
-081369030013 99999
05625
PKS.BLAMBANGAN PAGAR
34152
07979
34152
07975
34152
DRG. AIDAWATI
04416
99999
DR EKA SISWANTINI
06062
34161
05059
PUSKESMAS JATIDATAR
06065
07978
10
03907
11
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/02/122012
01/01/2013
31/12/2013
10000
PER/06/122012
01/01/2013
31/12/2013
3500
PER/02/012012
01/07/2012
30/06/2013
1000
PER/02/012012
01/07/2012
30/06/2013
3000
PER/04/122012
01/01/2013
31/12/2013
7000
PER/09/122012
SENIN, SELASA, RABU, UMUM (SHIFT 05,SHIFT
02,SHIFT 01,SHIFT 04,SHIFT
KAMIS, JUM'AT,
06,SHIFT 03)
SABTU
01/01/2013
31/12/2013
14000
99999
PER/09/122012
01/01/2013
31/12/2013
10000
34152
PER/09/122012
SENIN, SELASA, RABU, UMUM (SHIFT 05,SHIFT
02,SHIFT 01,SHIFT 04,SHIFT
KAMIS, JUM'AT,
06,SHIFT 03)
SABTU
01/01/2013
31/12/2013
7500
34152
PER/02/012012
01/07/2012
30/06/2013
1000
PUSKESMAS MAKARTITAMA
-08127200379 34595
PER/07/122012
01/01/2013
31/12/2013
7000
07707
PUSKESMAS MENGGALA
34698
FALINDA
01/02/2012
31/01/2013
2000
12
07014
34164
DR. VERLISTYAWATI
PER/08/122012
01/01/2013
31/12/2013
14000
13
07977
PUSKESMAS PONCOWATI
34152
14
05691
34152
15
07650
34698
16
06600
17
04980
18
03495
DR MAYA METISSA
19
07496
20
07738
21
DR FIKRI
PER/02/012012
01/07/2012
30/06/2013
1000
DRASZURUF RINOVI R
PER/09/122012
01/01/2013
31/12/2013
3500
DEDI MULYADI, SE
PER/10/122012
01/01/2013
31/12/2013
1500
34155
SYAHLAN MURSID
PER/03/122012
01/01/2013
31/12/2013
14000
99999
RUSLAN KRISNO
PER/05/122012
01/01/2013
31/12/2013
50000
0721-21785
34572
DR HJ MAYA METISA
PER/01/122012
01/01/2013
31/12/2013
7000
34554
PER/03/092012
01/09/2012
31/08/2013
1000
34554
PER/01/032012
01/03/2012
28/02/2013
1000
07497
DR. HERLENA
34163
DR. HERLENA
PER/02/092012
01/09/2012
31/08/2013
3000
22
08013
DR.SUMANTRI
34161
DR.SUMANTRI
PER/01/102012
01/10/2012
30/09/2013
400
23
07739
34871
PER/04/022012
01/02/2012
31/01/2013
1500
24
08161
34595
SUHARTATI, ES
PER/11/122012
01/01/2013
31/12/2013
1000
RI244010
PKR102001
Halaman :
Tanggal :
62/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
25
05312
PPK REIMBURSED
JL JEND SUDIRMAN
34554
DR MAYA METISSA
26
05095
PKM JATIDATAR
99999
27
03497
0724-22095
34511
28
05031
0725-529828
34161
29
07708
RSUD MENGGALA
0726-21146
34698
30
08061
0725-25333
31
04909
32
04908
33
03981
34
96277
RI244010
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
PER/02/01200
JUMLAH
TTG
31/12/2007
25000
70
PER/12/122012
01/01/2013
31/12/2013
8000
DR MARYANTO
PER/13/122012
01/01/2013
31/12/2013
14000
0726-21222
PER/15/122012
01/01/2013
31/12/2013
5000
34152
0725-25989
PER/02/102012
01/10/2012
30/09/2013
2000
0725-527476
99999
PER/14/122012
01/01/2013
31/12/2013
20000
99999
-0724-21941
34554
NURMAN,SE.MM
PER/17/122012
01/01/2013
31/12/2013
7000
0725-265039
34163
ESTHERLINA GINTING
PER/16/122012
01/01/2013
30/06/2013
50000
70
PKR102001
Halaman :
Tanggal :
63/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/32/122012
01/12/2012
31/12/2012
5000
PER/33/122012
01/12/2012
31/12/2012
1500
PER/34/122012
01/12/2012
31/12/2012
5000
PER/07/012013
01/01/2013
31/12/2013
5000
PER/36/102012
01/10/2012
30/09/2013
10000
PER/18/042012
01/04/2012
31/03/2013
10000
PER/50/PKS/102011
01/10/2011
30/09/2012
PER/19/042012
01/04/2012
31/03/2013
PER/46/122012
01/12/2012
30/11/2013
PER/08/012013
01/01/2013
31/12/2013
PER/51/062007
01/06/2007
31/05/2008
021-5732940
PER/27/062008
01/06/2008
31/12/2008
PER/29/062008
01/06/2008
31/12/2008
7000
-3917714
7000
-5363950
7000
03588
-5481140
7000
18
04316
-8630654
-86604256
7000
19
00014
OPTIK KF 48
13110
20
03592
OPTIK A KASOEM
JL CIKINI NO 18
021-3151070
10330
021-3909748
21
00011
021-3812849
10110
ABOE
22
03771
APOTIK KF RSCM
JL DIPONEGORO NO 71 JAKARTA
-021-3903958 10430
7000
23
03595
OPTIK A KASOEM
-5403854
7000
24
04116
OPTIK KARINA
-5734453
7000
25
03593
JL PASAR BARU NO 7
7000
26
03598
7000
27
04037
OPTIK TREND
-30015550
7000
28
04040
OPTIK TREND
-56953765
7000
29
03594
OPTIK TREND
-54382647
7000
03180
021-4219548
10110
021-42801341
03181
021-4246359
10110
021-4224041
00021
021-3146194
10110
021-3145194
00020
BP THAMRIN SERDANG
021-429519
10110
021-429519
07545
021-4222299
10520
021-4222299
PROF.HABE
07780
021-42800812 10440
00109
021-4250451
10110
021-4266546
07838
RS SS MEDIKA
JL SALEMBA I NO 11
021-3913336
10430
021-3926687
08121
RSIA EVASARI
021-4202851
13110
021-4209725
10
00009
APOTIK KF 2
021-3844783
10240
11
00006
APOTIK KF 4
021-3813272
10140
021-3518407
12
00007
APOTIK KF 6
021-5720279
10130
13
03772
021-5745287
10044
14
03586
15
00010
APOTIK KF 5
16
00029
17
RI244010
08/UH/OKF/IV/2008
01/04/2008
31/12/2008
003/KPO-PK/VII/2008
01/04/2008
31/12/2008
31-OS/VII/2008
01/04/2008
31/12/2008
7000
PKR102001
Halaman :
Tanggal :
64/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
30
04332
RI244010
TREND OPTIK
12210
PPK II
S
RS
APT
HARI BUKA
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PKR102001
Halaman :
Tanggal :
65/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/28/122012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
KAMIS, JUM'AT,
GIGI (SHIFT 1), SALIN (SHIFT
SABTU
1)
01/12/2012
28/02/2013
7000
PER/21/122012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
KAMIS, JUM'AT,
GIGI (SHIFT 1), SALIN (SHIFT
SABTU
1)
01/12/2012
28/02/2013
7000
PER/22/122012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
KAMIS, JUM'AT,
GIGI (SHIFT 1), SALIN (SHIFT
SABTU
1)
01/12/2012
28/02/2013
7000
PER/25/122012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
KAMIS, JUM'AT,
GIGI (SHIFT 1), SALIN (SHIFT
SABTU
1)
01/12/2012
28/02/2013
7000
021-56940316 DR SALIMAR
PER/26/122012
01/12/2012
28/02/2013
7000
021-70601471 11170
DR SALIMAR
PER/24/122012
01/12/2012
28/02/2013
7000
021-56941907 11170
DR SALIMAR
PER/27/122012
01/12/2012
28/02/2013
7000
PUSKESMAS KEMBANGAN
021-5870834
PER/23/122012
01/12/2012
28/02/2013
7000
00043
ARMADA MEDIKA II
021-55964117 14130
PER/05/012013
01/01/2013
31/12/2013
7000
10
05019
021-5811502
11220
PER/04/012013
01/01/2013
31/12/2013
7000
11
05018
JL BUGIS RAYA NO 51
021-5811502
11220
021-5811502
PER/03/012013
01/01/2013
31/12/2013
7000
12
00040
021-5675259
11150
021-5679165
PER/02/012013
01/01/2013
31/12/2013
7000
13
04880
11150
PER/01/012013
01/01/2013
31/12/2013
7000
14
07578
021-5485117
11510
PER/09/052012
01/05/2012
30/04/2013
7000
15
07579
RB PEJUANGAN KEMBANGAN
021-5811502
11510
021-5823598
BENGKA SIMBOLON
PER/09/052012
01/05/2012
30/04/2013
7000
16
05570
RS BHAKTI MULIA
021-5481625
11110
021-5331544
DR YUSTITIA
PER/20/122012
01/12/2012
31/12/2013
17
05569
RS PATRIA IKKT
021-5308981
11480
PER/06/022012
01/02/2012
31/01/2013
18
07567
11520
021-5828499
PER/01/112011
01/11/2011
31/10/2012
19
05889
RS SUMBER WARAS
021-5682011
11110
PER/10/062010
01/06/2012
31/10/2012
20
05644
APOTEK GROGOL
021-5671357
11140
APOTEK GROGOL
PER/13/102012
01/10/2012
31/12/2013
21
05578
APOTEK IDAMAN
021-4219548
11140
M PUJONO
PER/09/062012
01/06/2012
31/05/2013
22
05864
APOTEK K 24 SLIPI
021-53690010 11480
PER/12/092012
01/09/2012
31/08/2013
23
06553
021-56952171 11170
021-5480882
PER/14/102012
01/10/2012
31/12/2013
24
05648
KF 254
021-5349063
11110
021-5349043
PER/14/102012
01/10/2012
31/12/2012
25
05645
KF 282
021-5363950
11410
PER/14/102012
01/10/2012
31/12/2013
26
05646
KF 96 SLIPI
SLIPI
021-5481140
11420
021-5350484
PER/14/102012
01/10/2012
31/12/2013
05758
021-5649433
11140
021-5633342
DR SALIMAR
05759
JL KEBON JERUK NO 2
021-5482387
11110
021-5482367
DR SALIMAR
05760
021-5482370
11150
05761
JL DR NURDIN I/35
021-56943089 11110
DR SALIMAR
05762
JL SEMANGKA RT 006/07
021-56940316 11220
05757
05763
07279
RI244010
11110
DR SYARIFAH AZIZAH
PKR102001
Halaman :
Tanggal :
66/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
27
05571
OPTIK TREND
021-70607443 11140
28
05572
OPTIK TREND 2
021-30015550 13220
29
05573
OPTIK TREND 3
021-78837952 12150
30
05574
OPTIK TREND 4
021-56953765 11140
31
05575
OPTIK TREND 5
32
05576
OPTIK TREND 6
RI244010
HARI BUKA
PPK II
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/08/052012
01/04/2012
31/03/2013
PER/08/052012
01/04/2012
31/03/2013
PER/10/052011
01/04/2011
31/03/2012
PER/10/052011
01/04/2011
31/03/2012
ITC PERMATA HIJAU GF BLOK A9 NO. 1-2 JL. LETJEN SOEPENO 021-53663324 12160
PER/10/052011
01/04/2011
31/03/2012
021-73451621 11310
PER/10/052011
01/04/2011
31/03/2012
PKR102001
Halaman :
Tanggal :
67/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/11/012013
01/01/2013
31/12/2013
7000
PER/14/012013
SENIN, SELASA, RABU, UMUM (SHIFT 01), GIGI
KAMIS, JUM'AT
(SHIFT 01), SALIN (SHIFT 01)
01/01/2013
31/01/2013
5000
PER/15/012013
SENIN, SELASA, RABU, UMUM (SHIFT 01), GIGI
KAMIS, JUM'AT
(SHIFT 01), SALIN (SHIFT 01)
01/01/2013
31/01/2013
6000
PER/18/012013
SENIN, SELASA, RABU, UMUM (SHIFT 01), GIGI
KAMIS, JUM'AT
(SHIFT 01), SALIN (SHIFT 01)
01/01/2013
31/01/2013
3500
PER/17/012013
01/01/2013
31/01/2013
3500
PER/16/012013
SENIN, SELASA, RABU, UMUM (SHIFT 01), GIGI
KAMIS, JUM'AT
(SHIFT 01), SALIN (SHIFT 1)
01/01/2013
31/01/2013
4000
PER/13/012013
SENIN, SELASA, RABU, UMUM (SHIFT 01), GIGI
KAMIS, JUM'AT
(SHIFT 01), SALIN (SHIFT 01)
01/01/2013
31/01/2013
6000
PER/01/012013
01/01/2013
31/12/2013
14000
PER/09/012013
01/01/2013
31/12/2013
7000
PER/05/012013
01/01/2013
31/12/2013
12000
01/01/2013
31/12/2013
7000
PER/06/012013
01/01/2013
31/12/2013
7000
021-43901357 14320
PER/03/012013
01/01/2013
31/12/2013
7000
JL.MALAKA HB NO 1B RT 016/06
KEL.ROROTAN,KEC.CILINCING,JAKARTA UTARA
021-44852641 14240
RACHYUDIN ACHMAD,SE
PER/04/012013
01/01/2013
31/12/2013
7000
021-92679357 14110
AGUNG MUHAREZA
01/01/2013
31/12/2013
7000
07387
021-43934695 14350
PER/12/012013
01/01/2013
31/12/2013
7000
17
06340
021-44835339 14340
H.M. BADAWI
01/01/2013
31/12/2013
7000
18
03776
021-4301787
14120
M.NUR HIDAYAT, ST
PER/10/012013
01/01/2013
31/12/2013
7000
19
05623
021-6506559
14340
021-6401411
PER/14/012012 &
HK.06.01/VII.1/294/2012
01/01/2012
31/12/2012
20
05518
RSUD KOJA
021-43938478 14110
021-4352401
DR.H.NUR ABADI
01/01/2012
01/12/2012
21
05621
RS PELABUHAN
021-4403026
14260
021-4403551
PER/01/012012
01/01/2012
31/12/2012
22
05624
JL ENGGANO NO 10 TJ PRIOK
PER/44/102012
01/10/2012
30/09/2013
23
05486
RS PURI MEDIKA
021-43903355 14330
PER/20/032012
01/03/2012
28/02/2013
24
05622
RS SATYA NEGARA
021-64715200 14250
PER/22/032012
01/03/2012
28/02/2013
25
05514
021-43934416 14110
DRS PUJIANTO
PER/33/062012
01/06/2012
31/05/2013
26
05513
APOTIK DELI
021-4309728
14110
021-4309728
PER/32/062012
01/06/2012
31/05/2013
27
05515
APOTIK SUNTER
021-6501863
14440
SUYANTO S.E
PER/35/0620012
01/06/2012
31/05/2013
00129
KLINIK KOLINLAMIL
021-43932316 14130
05699
021-45853300 14130
05700
021-4367168
14230
05701
021-68855884 14240
021-6507745
05698
DR.SRI SUSILOWATI
05697
14220
05696
021-43908923 14140
00132
021-4414662
14240
DR HADI SANTOSO
07821
RACHYUDIN, SE
10
07091
021-4303619
14110
021-4303619
DR EMPAT PATONAH
11
06221
021-4369130
14110
DRG.LIESYE VERONICA
12
04189
021-4301183
14140
13
05429
14
06447
15
05531
16
RI244010
PKR102001
Halaman :
Tanggal :
68/239
15-01-2013
16:22:40
PEMILIK
NO
NO. PPK
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
28
05516
APOTIK WARAKAS
021-43930050 14110
29
07388
021-65833185 14130
RI244010
SUYANTO SE
HARI BUKA
PPK II
S
RS
APT
v
v
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/34/062012
01/06/2012
31/05/2013
PER/36/072012
01/07/2012
30/06/2013
PKR102001
Halaman :
Tanggal :
69/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/14/022012
01/02/2012
31/01/2013
8002
PER/13/022012
01/02/2012
31/01/2013
7000
PER/12/022012
01/02/2012
31/01/2013
8000
PER/01/2013
01/01/2013
31/12/2013
7000
PER/05/012013
01/01/2013
31/12/2013
7000
PER/10/012013
01/01/2013
31/12/2013
5000
PER/08/012013
01/01/2013
31/12/2013
7000
PER/02/012013
01/01/2013
31/12/2013
12000
13210
021-47862297
PER/03/012013
01/01/2013
31/12/2013
9050
021-4895351
13230
PER/06/012013
01/01/2013
31/12/2013
7000
13310
021-8516274
DR RUDI SUPRAPTO
PER/09/012013
01/01/2013
31/12/2013
7000
07999
KLINIK RATNASARI
021-4754512
13220
NADIR K HUSSAIN
PER/07/012013
01/01/2013
31/12/2013
7000
13
04998
021-46823314 13150
021-46823314
PER/04/012013
01/01/2013
31/12/2013
7000
14
05683
021-86602525 13150
021-86600712
PER/22/072012
01/07/2012
31/12/2012
15
05544
021-4718058
13220
021-4718058
16
05542
JL.MATRAMAN RAYA NO 55
021-8506208
13230
17
05543
JL.PAHLAWAN REVOLUSI NO 43
021-8615154
13150
021-8612721
18
05545
JL.PEMUDA NO 3 C
021-4710489
13130
19
05540
APOTEK RAWAMANGUN
JL.RAYA KEDONDONG NO 10
021-4897351
20
05941
21
05548
OPTIK MIKEDA
JL.PERSERIKATAN NO 3 RAWAMANGUN
05825
021-8195146
13110
021-8195146
DR SRI HARUMINI
05826
021-8581957
13110
05827
021-4890519
13110
021-4890519
DR YUSMANIAR
00096
BP MH THAMRIN TEGALAN
JL.TEGALAN NO 30
021-8581344
13140
021-8581344
04152
021-46829425 13210
021-46829425
06802
0856-92789757 13430
07998
KLINIK FAIRY
021-86611407 13430
DR DEVI IDHAM
00094
021-70311938 13140
00092
JL.RAYA BEKASI KM 17
021-4608448
10
05984
KLINIK MELATI
11
06801
12
RI244010
PER/02/092007
01/09/2007
31/05/2008
PER/25A/072012
01/07/2012
31/12/2012
PER/02/092007
01/09/2007
31/05/2008
021-4710489
PER/02/092007
01/09/2007
31/05/2008
13460
021-4897351
A.SUBAGIO
PER/07/012012
01/01/2012
31/12/2012
021-8519308
13110
PER/09/012012
01/01/2012
31/12/2012
021-4896077
13140
021-4896077
PER/08/012012
01/01/2012
31/12/2012
BUDI HERMAWAN
v
v
v
v
v
PKR102001
Halaman :
Tanggal :
70/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
05764
021-7943509
12790
05767
PKM PANCORAN
021-7974024
12760
05766
PKM SETIABUDI
021-8295529
05765
PKM TEBET
021-8314955
06719
07385
RB FAKHIRA 24 JAM
021-83707368 12970
07649
RS AGUNG
021-8294955
12970
021-8305791
DR DWINANTO ARIWIBOWO
05882
RS TEBET
021-8307540
12810
021-8311760
RI244010
HARI BUKA
PPK II
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/12/122012
01/01/2013
31/12/2013
7000
PER/13/122012
01/01/2013
31/12/2013
7000
12980
PER/14/122012
01/01/2013
31/12/2013
7000
12810
021-8314955
PER/15/122012
01/01/2013
31/12/2013
7500
PER/01/012013
01/01/2013
31/12/2013
7000
PER/03/012012
01/01/2012
31/12/2012
PER/01/012011
01/01/2012
31/12/2012
PER/04/012012
01/01/2012
31/12/2012
7000
PKR102001
Halaman :
Tanggal :
71/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/05/012013
01/01/2013
31/12/2013
7000
PER/06/012013
01/01/2013
13/12/2013
7000
PER/07/012013
01/01/2013
31/12/2013
7000
021-7356085
PER/11/012013
01/01/2013
31/12/2013
7000
12110
021-7669454
PER/09/012013
01/01/2013
31/12/2013
7000
021-7864707
12110
021-7864707
01/01/2013
31/12/2013
7000
021-7811265
12110
021-7811265
PER/10/012013
01/01/2013
31/12/2013
7000
021-98287097 12110
PER/02/012013
01/01/2013
31/12/2013
14000
06982
PER/03/012013
01/01/2013
31/12/2013
7000
10
03198
KLINIK CIREUNDEU
JL CIPUTAT RAYA NO 21
021-7430857
021-7430857
PER/01/012013
01/01/2013
31/12/2013
11000
11
05473
021-75905557 12410
PER/04/012013
01/01/2013
31/12/2013
7000
12
00054
RS MARINIR CILANDAK
021-7805296
12560
021-7812764
PER/28/122011
01/12/2011
30/11/2012
13
00052
-7501524
12430
-7690123
PER/29/122011
01/01/2012
31/12/2012
14
06200
RSIA AULIA
021-7270208
12730
021-7866057
PT LIAVANSYA
PER/27/062012
01/06/2012
31/05/2013
15
05888
021-7805296
12110
RS MARINIR
PER/26/122009
01/12/2009
30/11/2010
16
05474
APOTEK CAHAYA
021-78844068 12430
PER/22/042012
01/04/2012
31/03/2013
17
03909
APOTIK TAROGONG
-027-7696857 12160
LILIK ANDRIANI
PER/23/062012
01/06/2012
31/05/2013
18
03774
OPTIK PRIKASIH
-021-75909929 12430
JENI HANDAJANI
PER/21/042012
01/04/2012
31/03/2013
19
05917
PROOPTIK
021-79184879 12420
PER/21/102009
01/10/2009
30/09/2010
20
04333
OPTIK A. KASOEM
-7248053
7000
21
03601
JL SULTAN HASSANUDIN NO 1
7000
22
03600
7000
00068
KLINIK KOSTRAD
021-72791424 12430
00051
JL AMBALUN NO 3 PD LABU
021-7513687
12430
00069
12430
05771
P KEC PESANGGRAHAN
021-7356087
12110
05769
021-7661613
05770
05768
05629
RI244010
12430
v
v
v
v
7000
7000
PKR102001
Halaman :
Tanggal :
72/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
06962
BALKESMAS MANGGARAI PT. KAI (PERSERO) JL. BUKIT DURI UTARA I NO. 1, KEL. MANGGARAI, KEC.
TEBET, JAKARTA SELATAN
021-8351587
12850
021-8351587
05750
021-6298090
10110
05749
P KEMAYORAN
021-4244277
05751
07515
05753
7
8
DR SLAMET HARDADI
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
SENIN, SELASA, RABU, UMUM (SHIFT 1), GIGI
(SHIFT 1)
KAMIS, JUM'AT
JUMLAH
TTG
PER/01/012012
01/01/2013
31/12/2013
7000
7000
021-6012240
PER/12/062012
01/06/2012
31/05/2013
10110
021-42801425
PER/17/082012
01/08/2012
31/08/2013
10110
PER/11/062012
01/06/2012
31/05/2013
7000
021-6504226,
65302051
14350
021-6517056
PER/16/08212
01/08/2012
31/07/2013
14000
RS TARAKAN
021-3503003
10110
01/01/2013
31/12/2013
06210
APOTEK MEDICARE
021-6326232
10110
PER/14/062012
01/06/2012
31/05/2013
05752
021-3812849
10110
021-3812849
PER/ 03 / 012013
01/01/2013
31/12/2013
RI244010
SUYANTO, SE
v
v
v
v
v
7000
PKR102001
Halaman :
Tanggal :
73/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/35/122012
01/12/2012
31/12/2013
7000
PER/36/122012
01/12/2012
31/12/2013
7000
PER/01/012013
01/01/2013
31/12/2013
7000
PER/10/042012
01/04/2012
31/03/2013
PER/11/042012
01/04/2012
31/03/2013
PER/02/012012
01/01/2012
31/12/2012
PER/02/012012
01/01/2012
31/12/2012
PER/11/042012
01/04/2012
31/03/2013
PER/03/012012
01/01/2012
31/12/2012
05740
P KEC MENTENG
021-3103439
10110
021-31904965
05741
021-3150427
10110
021-31903174
05742
KLINIK AFIA
021-3901458
10110
05747
RS AL MINTOHARJO
021-5703081
10110
021-5711997
05748
021-3154050
10340
021-3146309
05746
APOTIK KF 6
-5720279
10110
05744
021-5745287
10110
05745
021-3154050
10340
021-3146309
05743
OPTIK A. KASOEM
021-3151070
10110
RI244010
HARI BUKA
PPK II
PKR102001
Halaman :
Tanggal :
74/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
05801
021-8718995
13110
021-8718995
05798
021-8773604
13110
05803
021-8003308
13110
021-8003308
05799
021-8720053
13110
05800
JL. OTISTA NO 82
05802
05792
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/14/062012
01/06/2012
31/05/2013
7000
PER/21/062012
01/06/2012
31/05/2013
7000
PER/16/062012
01/06/2012
31/05/2013
7000
PER/17/062012
01/06/2012
31/05/2013
7000
021-85903677 13110
PER/13/062012
01/06/2012
31/05/2013
7000
021-87781628 13110
PER/18/062012
01/06/2012
31/05/2013
7000
021-8002184
13630
05787
BP MH THAMRIN PD GEDE
021-8093602
13240
06029
021-87720807 13730
10
07008
KLINIK ARDITA
021-84312796 13650
11
08059
021-87783668 13130
12
05790
JL.PONDOK GEDE N0 41
021-8400722
13
08060
14
07816
021-8096222
15
05791
16
05788
17
PER/20/012013
01/01/2013
31/12/2013
7000
PER/15/012013
01/01/2013
31/12/2013
7000
PER/21/012013
01/01/2013
31/12/2013
7000
PER/22/2013
01/01/2013
31/12/2013
14000
PER/14/102012
01/10/2012
30/09/2013
7000
021-8400722
DRG. SUHERMAN
PER/19/012013
01/01/2013
31/12/2013
7500
021-98685464 13240
PER/13/102012
01/10/2012
30/09/2013
7000
13630
PER/12/042012
01/04/2012
31/03/2013
7000
021-87798796 13210
PER/18/012012
01/01/2013
31/12/2013
1600
021-8409244
13560
021-8100708
PER/16/012013
01/01/2013
31/12/2013
7000
05789
KLINIK TJAKRA
021-8401677
13120
PER/17/012013
01/01/2013
31/12/2013
9000
18
06570
RB ANNISA CIRACAS
021-87720807 13810
19
06571
RB TJAKRA
021-8401677
20
05795
RS POLRI SUKANTO
21
05796
RS PASAR REBO
22
05797
RI244010
13230
DR MULYANTI
PER/09/JPK/012010
01/03/2010
28/02/2011
7000
13120
PER/08/JPK/022010
01/03/2010
28/02/2011
9000
021-8093288
13820
021-8094005
BRIGJEN.POL.BUDI SISWANTO,
MM
PER/10/032012
01/03/2012
28/02/2013
021-8400109
13760
021-840710
PER/11/012012
01/02/2012
31/03/2013
021-8092317
13210
021-8092445
DR. YVONNE.N.J.PALIJAMA,SP
RAD, MARS
PER/09/032012
01/03/2012
28/02/2013
PKR102001
Halaman :
Tanggal :
75/239
15-01-2013
16:22:40
PEMILIK
NO
NO. PPK
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
05756
JL.RAJASA III
021-7236636
12930
05754
021-5271405
12110
07852
BALKESMAS ASISI
021-8311340
12930
RI244010
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/01/012013
01/01/2013
30/06/2013
7000
PER/01/012013
01/01/2013
30/06/2013
7000
PER/01/012013
01/01/2013
30/06/2013
14000
PKR102001
Halaman :
Tanggal :
76/239
15-01-2013
16:22:40
PEMILIK
NO
NO. PPK
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/02/072012
01/07/2012
30/06/2013
7000
PER/03/072012
SENIN, SELASA, RABU, UMUM (SHIFT 01), GIGI
(SHIFT 01), SALIN (SHIFT 01)
KAMIS, JUM'AT,
SABTU
01/07/2012
30/06/2013
7000
01/07/2012
30/06/2013
7000
01/07/2012
30/06/2013
7000
021-66601020 AFFENDY
PER/04/012013
01/01/2013
31/12/2013
7000
PER/05/012013
01/01/2013
31/12/2013
14000
05716
021-55959125 14440
05717
JL KAPUK KAMAL 28
021-6694917
14440
021-6690881
DRG WIDYANINGSIH
05714
021-6313651
11510
021-6318822
DR SILVIA,MAP
05715
021-6694956
14440
06294
021-66601062 14440
05713
021-66603403 14440
RI244010
HARI BUKA
PPK II
PKR102001
Halaman :
Tanggal :
77/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
05734
JL KAMAL RAYA
021-54398366 11110
021-6191756
05738
021-54390576 11110
05730
05725
05722
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/02/122012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
KAMIS, JUM'AT,
GIGI (SHIFT 1), SALIN (SHIFT
SABTU
1)
PER/03/122012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
KAMIS, JUM'AT,
GIGI (SHIFT 1), SALIN (SHIFT
SABTU
1,SHIFT 2)
01/12/2012
31/12/2013
021-68620557 11110
021-7379102
PER/04/012013
01/01/2013
31/12/2013
5000
021-93133089 11110
021-75873756 DR HARYANI
PER/03/012012
01/01/2013
31/12/2013
3000
021-5557331
11150
021-5404619
DR ROBBY HILMAN,SPM
PER/05/012013
01/01/2013
31/12/2013
7000
05723
021-5557331
11110
021-5404619
PER/06/012013
01/01/2013
31/12/2013
7000
07278
JL DAAN MOGOT KM 13
021-5409082
11110
PER/01/052012
01/05/2012
30/04/2013
14000
07914
021-91320317 11110
CV KAINA HEALTHCARE
PER/01/062012
01/06/2012
31/05/2013
7000
07321
021-5447798
11110
021-5447897
DR ATHENAWATI UNANG
PER/02/062012
01/06/2012
31/05/2013
7000
10
05724
021-5456027
11110
021-5456027
PER/02/012013
01/01/2013
31/12/2013
7000
11
06956
021-54396298 11730
021-6194581
YAYASAN MH THAMRIN
PER/01/122012
01/12/2012
31/12/2013
7000
12
05729
021-55963466 11110
PER 01/012013
01/01/2013
31/12/2013
7000
13
05731
021-70605247 11110
PER/08/012013
01/01/2013
31/12/2013
14000
14
05727
021-54373583 11110
PER/07/012013
01/01/2013
31/12/2013
7000
15
05733
RSUD CENGKARENG
021-54382793 11730
021-5442692
DR NUR ABADI
ADN/01/102012
01/10/2012
31/12/2012
16
5756
021-7336699
021-7333598
PER/01/032012
01/03/2012
28/02/2013
17
06608
OPTIK RS CENGKARENG
021-97610296 11730
CV HULWANI
PER/01/JPK/042012
01/04/2012
31/03/2013
RI244010
11110
DR SALIMAR
DR RADOT M SIMATUPANG
01/12/2012
28/02/2013
v
v
7000
PKR102001
Halaman :
Tanggal :
78/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/38/122012
01/12/2012
31/12/2013
7000
PER/35/122013
01/12/2012
31/12/2013
7000
PER/36/122013
01/12/2012
31/12/2013
7000
PER/37/122012
01/12/2012
31/12/2013
7000
PER/33/122012
01/12/2012
31/12/2013
7000
13110
PER/34/122012
01/12/2012
31/12/2013
7000
021-86608372 13110
PER/39/122012
01/12/2012
31/12/2013
7000
021-70990050 13110
PER/40/122012
01/12/2012
31/12/2013
7000
05820
021-86903157 13110
PER/41/122012
01/12/2012
31/12/2013
7000
10
05804
021-70308160 13150
H. I DJAJADISASTRA
PER/01/012013
01/01/2013
31/12/2013
8500
11
05807
021-46827547 13210
PER/04/012013
01/01/2013
31/12/2013
10000
12
05805
021-86603270 13110
PER/02/012013
01/01/2013
31/12/2013
7000
13
05808
021-46826904 13130
PER/05/012013
01/01/2013
31/12/2013
10000
14
05806
JL.TIPAR CAKUNG NO 33
021-9236211
021-4608448
PER/03/012013
01/01/2013
31/12/2013
7200
15
05809
KLINIK PUTEWA
021-70302043 13220
HJ. SURYANI, SE
PER/06/012013
01/01/2013
31/12/2013
7000
16
07183
021-99542131 13950
PER/07/012013
01/01/2013
31/12/2013
4010
17
05813
RS DUREN SAWIT
021-8628686
021-8628686
PER/07/012012
01/01/2012
31/12/2012
18
07364
19
05814
021-8622491
20
07493
21
07221
22
05812
23
24
05822
021-8661052
13110
05816
021-46829710 13110
05817
JL STASIUN CAKUNG KM 4
021-4807828
13110
05818
JL RAYA BEKASI KM 26
021-
13110
05821
021-4608446
13110
05824
JL KAMPUNG BARU
05823
05819
13140
13220
PER/18A/062012
01/06/2012
31/12/2012
13460
PER/09/032012
01/03/2012
28/02/2013
13110
PER/29/082012
01/08/2012
31/10/2012
021-4802192
13940
PER/30/092012
01/04/2012
31/03/2013
APOTIK PUTEWA
021-70302043 13240
PER/08/022012
01/02/2012
31/01/2013
06377
021-8622511
13460
ROSIDIN
PER/31/112012
01/11/2012
31/10/2013
06961
JL. DUREN SAWIT BARU NO. 2 (RS DUREN SAWIT) KEL. DUREN 021-8628686
SAWIT, KEC. DUREN SAWIT, JAKARTA TIMUR.
13440
HARIS APRIYANTO
PER/32/112012
01/11/2012
31/10/2013
021-44820909 14140
021-44820068
PER/TC/02/112005
01/11/2005
30/11/2006
10000
021-46822879 13910
021-4608863
PER/TC/01/012011
15/01/2011
14/01/2012
10000
PER/TC/01/012013
14/01/2013
13/01/2014
PER/TC/03/062011
01/06/2011
31/08/2011
25
26
27
28
RI244010
021-86604256 13460
JL PULOMAS BARAT VI NO 20
021-70302043 SURYANI
13110
021-4723332
13210
021-4718081
v
DR SRI HARTATI , NHT
PKR102001
Halaman :
Tanggal :
79/239
15-01-2013
16:22:40
PEMILIK
NO
NO. PPK
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
29
RI244010
13110
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
PER/TC/02/062012
JUMLAH
TTG
01/06/2013
PKR102001
Halaman :
Tanggal :
80/239
15-01-2013
16:22:40
PEMILIK
NO
NO. PPK
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/24/122012
01/12/2012
31/12/2013
7000
PER/28/122012
01/12/2012
31/12/2013
7000
PER/27/122012
01/12/2012
31/12/2013
7000
021-7257810
PER/25/122012
01/12/2012
31/12/2013
7000
12110
021-7269603
PER/26/122012
01/12/2012
31/12/2013
7000
021-7228612
12110
021-7228612
PER/33/122012
01/12/2012
31/12/2013
7000
021-7223458
12110
021-7223458
PER/34/122012
01/12/2012
31/12/2013
7000
021-7233832
12110
PER/30/122012
01/12/2012
31/12/2013
7000
05784
021-7262979
12110
021-7262979
PER/32/122012
01/12/2012
31/12/2013
7000
10
05781
021-7651435
12110
021-7651435
PER/29/122012
01/12/2012
31/12/2013
7000
11
05783
021-7244166
12110
021-7244166
PER/31/122012
01/12/2012
31/12/2013
7000
12
99999
CABANG SETEMPAT
12110
13
05829
021-7243124
12160
021-7251495
05776
021-7220274
12160
021-7233918
05780
021-7245439
12110
021-7245439
05779
021-7237962
12110
021-7237962
05777
021-7257810
12110
05778
021-7269603
05785
05786
05782
RI244010
7000
v
PT. KIMIA FARMA
PER/06/062012
01/06/2012
31/05/2013
PKR102001
Halaman :
Tanggal :
81/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/17/122012
01/12/2012
31/12/2012
7000
PER/18/122012
01/12/2012
31/12/2012
7000
01/12/2012
31/12/2012
7000
01/01/2013
31/12/2013
7000
PER/07/012013
01/01/2013
31/12/2013
7000
PER/06/012013
01/01/2013
31/12/2013
7000
PER/10/012013
01/01/2013
31/12/2013
7000
PER/05/012013
01/01/2013
31/12/2013
7000
PER/04/012013
01/01/2013
31/12/2013
7000
JL. BARU CILINCING NO.9 RT/RW.001/01 KEL. CILINCING KEC. 021-92298353 14110
CILINCING
021-4303619
01/01/2013
31/12/2013
7000
JL KESEMEK NO 3 - 5
021-4403101
14130
021-4403101
PER/08/012013
01/01/2013
31/12/2013
7000
021-4400778
14140
021-4400782
PER/11/022012
01/02/2012
31/12/2012
05706
JL MADYA KEBANTENAN IV
021-4412889
14130
021-4412889
DINAS KESEHATAN
05707
021-4404703
14120
021-4404703
DINAS KESEHATAN
05705
021-4400351
14130
DINAS KESEHATAN
06386
021-44850122 14110
05720
BP UMUM LESTARI I
021-43922950 14140
BD SRI LESTARI
05710
JL RAYA CILINCING NO 74
021-4411281
021-4411281
06546
021-43933064 14110
05709
021-44820909 14130
05708
JL LAMPUNG NO 1 MARUNDA
021-44851525 14120
10
07040
11
05721
12
05718
RI244010
HARI BUKA
PPK II
14120
PKR102001
Halaman :
Tanggal :
82/239
15-01-2013
16:22:40
PEMILIK
NO
NO. PPK
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
05702
021-6452148
10110
DR SALIMAR
05704
021-6297752
11110
DRG BAMBANG
07441
14110
RI244010
HARI BUKA
PPK II
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
01/01/2013
31/12/2013
01/12/2012
31/12/2013
7000
01/08/2012
31/07/2013
140000
PER/03/082012
PKR102001
Halaman :
Tanggal :
83/239
15-01-2013
16:22:40
PEMILIK
NO
NO. PPK
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
06874
RI244010
021-83795988 12840
021-8295593
ABDILLAH USMAN
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
PER/01/012013
JUMLAH
TTG
30/06/2013
7000
PKR102001
Halaman :
Tanggal :
84/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
07577
RI244010
KLINIK HAYANA
021-7981876
12780
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
31/12/2012
7000
PKR102001
Halaman :
Tanggal :
85/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/20/012013
01/01/2013
30/04/2013
8528
PER/05/012013
01/01/2013
31/12/2013
7000
PER/09/012013
01/01/2013
31/12/2013
7000
PER/03/012013
01/01/2013
31/12/2013
7000
PER/22/012013
01/01/2013
31/12/2013
7000
PER/04/012013
01/01/2013
31/12/2013
14000
NANO ROHANA
PER/08/012013
01/01/2013
31/12/2013
10000
YUDI PRIHARTANTO, SH
01/01/2013
31/12/2013
14000
022-76767338 40115
PT. KAI
PER/27/012013
01/01/2013
31/12/2013
7000
JL ANGGREK NO 25 BANDUNG
022-7274463
40115
DR.SRI UTAMI
PER/01/012013
01/01/2013
31/12/2013
7000
BP. HIKMAH
022-7103275
40172
NANO ROHANA
PER/07/012013
01/01/2013
31/12/2013
14000
04922
BP. HIKMAH II
022-78417015 40284
NANO ROHANA
PER/12/012013
01/01/2013
31/12/2013
10000
13
04929
022-7300827
40262
PER/15/012013
01/01/2013
31/12/2013
7000
14
05487
022-2787155
40391
PER/21/012013
01/01/2013
31/12/2013
7000
15
04931
022-7205204
40182
PER/17/012013
01/01/2013
31/12/2013
7000
16
04091
40142
DR SRI WAHYUDIATI
PER/10/012013
01/01/2013
31/12/2013
7000
17
04945
-08122420309 40183
DR. SUSATYO
PER/19/012013
01/01/2013
31/12/2013
7000
18
04930
40296
PER/16/012013
01/01/2013
31/12/2013
7000
19
06763
DRG NUKE
081-221572020 40376
DRG. NUKE
PER/26/012013
01/01/2013
31/12/2013
20
06427
DRG. NINA
40182
DRG NINA
PER/24/012013
01/01/2013
28/02/2013
7000
21
04944
022-70712444 40153
DRG. SELLY
PER/18/012013
01/01/2013
31/12/2013
7000
22
00885
KIRANA MEDIKA
40121
PER/02/012013
01/01/2013
31/12/2013
7000
23
06362
KLINIK AMANAH
022-7275907
40142
YUDI PRIHARTANTO
PER/23/012013
01/01/2013
31/12/2013
14000
24
04927
KLINIK AN NUR
022-2042213
40142
022-2031922
01/01/2013
28/02/2013
8000
25
06428
022-7564929
40142
AGUS IRIANBRATA
01/01/2013
31/12/2013
7000
04947
022-2512497
40133
UNPAD
00969
BP AMPERA IV
022-6026657
40212
H.T. SUHATA
03393
BP MITRA MULYA
022-70447454 40233
MULYATI
00923
BP PERDITA
022-7807941
40142
LENNY ROCHAYATI
05489
BP PRAPATAN LIMA
022-7301918
40115
ARIANA INDRAWATI T
00935
BP SELAMAT I
022-7508197
40212
DR. MAGDALIZA
03380
BP UJUNGBERUNG
022-7801784
40191
04921
022-70054011 40252
07309
10
00882
BP. DAHLIA
11
01076
12
RI244010
PER/25/012013
7000
Halaman :
Tanggal :
86/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
26
04928
KLINIK SUKAGALIH
022-92755494 40142
27
08088
022-7208284
40124
28
07310
022-4262915
29
06793
RS. SARININGSIH
30
03418
RS MATA CICENDO
31
03396
32
HARI BUKA
PPK II
S
RS
DENNY N
YAYASAN AL ISLAM
40191
PMI
40115
JL CICENDO NO 4 BANDUNG
022-4231280
40191
022-4201962
JL PASTEUR NO 38 BANDUNG
-2034953
40161
-2030087
03397
-022-7811794 40162
33
06118
RS AL ISLAM BANDUNG
022-7565588
40286
34
06922
RS PINDAD
022-7321964
35
03423
APOTEK LUBESTA
36
03422
37
04747
38
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
PER/14/012013
31/12/2013
14000
KAMIS, JUM'AT,
SABTU
01/11/2012
31/12/2013
PER/27/012013
01/01/2013
31/12/2013
PER/33/012013
01/01/2013
01/12/2013
PER/30/012013
01/01/2013
01/12/2013
7000
PER/29/012013
01/01/2013
31/12/2013
7000
PER/31/012013
01/01/2013
31/12/2013
7000
022-7563233
PER/039/012012
01/01/2012
31/12/2012
40284
022-7309807
PER/061/102012
01/11/2012
31/12/2013
022-7801783
40162
LUSY HANDAYANI
PER/38/012013
01/01/2013
31/12/2013
7000
-7800207
40162
PER/37/012013
01/01/2013
31/12/2013
7000
APOTEK PEDULI
022-70797466 40121
AMIN FATHONI
PER/043/012012
01/01/2012
31/12/2012
03418
40115
PER/30/012012
01/01/2013
01/12/2013
7000
39
03432
OPTIK BANDOENG
-7275438
40182
PER/34/012013
01/01/2013
31/12/2013
7000
40
03427
JL A YANI NO 830
40135
ELLY MARIA
PER/35/012013
01/01/2013
31/12/2013
7000
41
03430
40191
ELLY MARIA
PER/35/012013
01/01/2013
31/12/2013
7000
42
03428
40162
ELLY MARIA
PER/35/012013
01/01/2013
31/12/2013
7000
43
03426
-4235846
40115
ELLY MARIA
PER/35/012013
01/01/2013
31/12/2013
7000
44
03429
40191
ELLY MARIA
PER/35/012013
01/01/2013
31/12/2013
7000
45
1100000000015 RS SARININGSIH
40142
PER/062/102012
01/11/2012
31/01/2013
46
1100000000014 RS PINDAD
022-7322468
40115
022-7322468
PER/047/052011
02/05/2011
30/04/2012
RI244010
v
v
UMUM (SHIFT I)
JUMLAH
TTG
v
v
7000
7010
PKR102001
Halaman :
Tanggal :
87/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/24/042012
01/05/2012
30/04/2013
PER/24/042012
01/05/2012
30/04/2013
PER/24/042012
01/05/2012
30/04/2013
DR NANA RATNASIH
PER/24/042012
01/05/2012
30/04/2013
2000
DR YULIATI
PER/24/042012
01/05/2012
30/04/2013
17211
DR TUTI PRAMURTIWATI
PER/24/042012
01/05/2012
30/04/2013
5000
-82421312
17340
DRG TJAHJANINGATI
PER/24/042012
01/05/2012
30/04/2013
5000
-8488737
17340
DR JULO NELMA T
PER/24/042012
01/05/2012
30/04/2013
JL RAYA PS KRANGGAN NO 26
-8454039
17211
PER/24/042012
01/05/2012
30/04/2013
3000
02794
-84991722
17211
DR NURHANIFAH MKM
PER/24/042012
01/05/2012
30/04/2013
2000
11
00491
-88970618
17211
DR DANIEL PANDELAKI
PER/24/042012
01/05/2012
30/04/2013
12
00525
PKM KRANJI
-86900850
17211
PER/24/042012
01/05/2012
30/04/2013
3000
13
00493
PKM PEJUANG
-88975253
17211
DR BAMBANG ISMANTO
PER/24/042012
01/05/2012
30/04/2013
14
02797
-8270106
17211
DR WISYANTI M.U S
PER/24/042012
01/05/2012
30/04/2013
15
00512
PKM PERUMNAS II
-88954619
17211
DR ROSARIA MANGIRI
PER/24/042012
01/05/2012
30/04/2013
500
16
00510
-8474402
17211
PER/24/042012
01/05/2012
30/04/2013
17
00513
-70292568
17211
DR ESTHER MM S
PER/24/042012
01/05/2012
30/04/2013
3000
18
00490
PKM SEROJA
-8853433
17211
DR RINA WIJAYA
PER/24/042012
01/05/2012
30/04/2013
19
00520
-89133568
17211
PER/24/042012
01/05/2012
30/04/2013
20
00559
-8225942
17211
-8204057
ESTER RUSLIM
PER/02/012013
01/01/2013
31/12/2013
7000
21
00562
-8251443
17211
-53667688
PER/03/012013
01/01/2013
31/12/2013
7000
22
06660
BP KASIH IBU
-33118634
17211
DR MELISA
PER/04/012013
01/01/2013
31/12/2013
2500
23
05995
021-91303916 17730
PER/05/012013
01/01/2013
31/12/2013
10000
24
00564
-8225926
17211
-82405393
KOSASIH, SE
PER/06/012013
01/01/2013
31/12/2013
25
00498
021-89106317 17520
-89106633
PER/07/012013
01/01/2013
31/12/2013
26
06495
-32960966
17211
TATI NURHAYATI
PER/08/012013
01/01/2013
31/12/2013
27
06398
KLINIK ASYPA
021-82427019 17211
PER/09/012013
01/01/2013
31/12/2013
28
00489
-8801954
-8824228
PER/10/012013
01/01/2013
31/12/2013
02788
-88347036
17211
DR TJATUR K WR
00502
-82602716
17211
DR RISMA HERAWATI
02783
17211
DR ABDUL KHALIK
03565
-8690050
17211
00541
-8206974
17211
02790
-84994628
00500
JL SWATANTRA NO 4 BEKASI
02792
02793
10
17211
021-46829425
RI244010
200
v
v
10000
6000
v
v
14000
10000
v
v
5000
Halaman :
Tanggal :
88/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
29
06297
021-8254677
17211
30
00532
KLINIK CEMPAKA II
-88357552
17520
31
00527
KLINIK DIPONEGORO
JL DIPONEGORO NO 26
-8817062
32
00570
KLINIK HANDAYANI
33
00556
34
03566
35
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/44/082012
01/01/2013
31/01/2013
PER/11/012013
01/01/2013
31/12/2013
7000
PER/12/012013
01/01/2013
31/12/2013
7000
PER/13/012013
01/01/2013
31/12/2013
3500
PER/14/012013
01/01/2013
31/12/2013
10000
PER/15/012013
01/01/2013
31/12/2013
5000
PER/25/012013
01/01/2013
31/12/2013
10000
PER/16/012013
01/01/2013
31/12/2013
7000
TATI NURHAYATI
PER/17/012013
01/01/2013
31/12/2013
PER/14/012013
01/01/2013
31/12/2013
10000
PER/18/012013
01/01/2013
31/12/2013
14000
DR HJ SRI EMILIA
PER/18/012013
01/01/2013
31/12/2013
14000
-8814523
DR SUMIYATI YUSUF
PER/19/012013
01/01/2013
31/12/2013
7000
17211
-88347895
PER/20/012013
01/01/2013
31/12/2013
5000
-8811266
17211
FENNY FEBRI
PER/21/012013
01/01/2013
31/12/2013
7000
-8866141-2
17211
-88958675
DR BENNY SUPRAPTO
PER/22/012013
01/01/2013
31/12/2013
10000
-8858316
17211
-88958675
BENNY SUPRAPTO
PER/22/012013
01/01/2013
31/12/2013
6500
00496
-88329135
17520
-88958675
BENNY SUPRAPTO
PER/22/012013
01/01/2013
31/12/2013
6000
47
06399
-89131010
17212
-89131010
PER/23/012013
01/01/2013
31/12/2013
6000
48
07595
KLINIK WIRATAMA
-88326918
17211
PER/24/012013
01/01/2013
31/12/2013
49
00568
JL RAYA NAROGONG KM 7 NO 45
-8253516
17211
-8253516
PER/14/012013
01/01/2013
31/12/2013
50
07394
-88882211
17211
-88973043
PER/29/062012
01/07/2012
30/06/2013
51
07793
RS BELLA
-8801776
17211
PER/14/032012
01/04/2012
31/03/2013
52
07478
RS CIBITUNG MEDIKA
-88323444
17211
-88323449
PER/33/072012
01/08/2012
31/07/2013
53
07319
RS GRAHA JUANDA
-8811832
17211
-88346880
DR TOMMY ARITONO
PER/26/062012
01/06/2012
31/05/2013
54
06960
-8221570
17211
PER/01/012012
01/01/2012
31/12/2012
55
07854
RS KARYA MEDIKA I
17211
PER/20/042012
01/05/2012
30/04/2013
56
04349
-88871202
17211
-88871203
PER/09/012012
01/04/2012
31/03/2013
-88357552
17211
-88346743
DR ENDANG WAHYUNINGSIH
-88336420
17550
HJ ASMAWATI AM.KEB
-8862936
17211
-8253516
KLINIK HUSADA
JL HASANUDIN NO 72 TAMBUN
021-8804337
17510
-8829852
DRS HARNOTO,APT
08058
-99877485
17211
36
06374
021-32959824 17520
37
06974
-89110027
17211
38
00569
-88987741
17211
-8253516
39
07011
-88958142
17211
40
07858
-89132587
17211
41
06618
-8814523
17211
42
00566
KLINIK SENTOSA
-8814968
43
00528
44
00540
45
00492
46
RI244010
DR. ALBERT
KAMIS, JUM'AT,
SABTU
14000
14000
14000
7000
PKR102001
Halaman :
Tanggal :
89/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
57
03571
58
07372
59
04128
60
00550
61
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
7000
17211
PER/05/012012
01/02/2012
31/01/2013
17211
-82618977
DR SINGGIH
PER/28/062011
01/07/2012
30/06/2013
JL PRAMUKA NO 37 BEKASI
-88959855
17211
-82430996
DRS PUJIANTO,APT
PER/02/012012
01/02/2012
31/01/2013
APOTIK BEKASI
-8801775
17211
-88342438
DRA. SUSILAWATI
PER/27/012013
01/01/2013
31/12/2013
7000
00551
APOTIK KARTINI
021-8801954
17211
-8824228
PER/28/012013
01/01/2013
31/12/2013
7000
62
04895
021-8841005
17211
PER/03/012012
01/02/2012
31/01/2013
63
03919
17211
PER/27/012011
01/02/2011
31/01/2012
7000
64
06953
-70392805
17211
PER/99/122011
01/12/2011
30/11/2012
14000
65
03574
-88342437
17211
PER/57/082012
01/08/2012
31/07/2013
7000
66
021-8221570
17211
PER/30/062012
02/06/2012
01/06/2013
67
17141
PER/62/102012
22/10/2012
22/10/2013
RI244010
-8803386
JUNAIDI
JOHANES POSO
PKR102001
Halaman :
Tanggal :
90/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
02988
KLINIK BHAYANGKARA
-0251-381357 16310
POLWIL BOGOR
04912
JL KAPTEN MUSLIHAT NO 16
0251-381357
16310
POLWIL BOGOR
00590
PKM PARUNG
-0251-615184 16330
07015
PKM CICANGKAL
16650
05479
021-75790143 16310
05482
06130
BP ANNISA AULIA
07179
BP AULIA MEDIKA
05480
10
HARI BUKA
PPK II
S
RS
APT
v
v
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
01/01/2013
31/12/2013
01/01/2012
31/12/2012
15000
v
v
7000
01/01/2013
31/12/2013
7000
DR RINI LESTARI
01/01/2012
31/12/2012
7000
DINAS KESEHATAN
01/01/2013
31/12/2013
7000
16310
BIDAN HJ NURYANI R
01/01/2011
31/12/2011
16310
DR NOVIA MIRALIA
01/01/2013
31/12/2013
7000
16810
SUSINAH HARUN
01/01/2013
31/12/2013
7000
BP BUNDA MULIA
021-5978058
16310
021-5977758
01/01/2013
31/12/2013
7000
00572
BP DR ALI
-87950827
16310
DR ALI MUCHTAR
01/01/2013
31/12/2013
10000
11
00609
BP HARIST MEDIKA
-021-8750337 16310
SUSAN FIER
01/01/2013
31/12/2013
7000
12
04914
BP OLYMPIC KIS
021-8763703
16310
OLYMPIC GROUP
01/01/2013
31/12/2013
7000
13
06988
16620
01/01/2013
31/12/2013
7000
14
07173
BP PERMATA HUSADA
021-87952811 16810
01/01/2013
31/12/2013
7000
15
05021
BP ZAM ZAM
HJ DR ADE FARIDAH
01/01/2013
31/12/2013
15050
16
00596
BP. CIBULUH
-0251-661946 16310
01/01/2013
31/12/2013
10700
17
00573
-0251-659024 16310
DR MURNIATY SOSSONG
01/01/2012
31/12/2012
7000
18
00619
BP. MEDISTIRA I
-021-8753991 16310
DR HAMRA HAMID
01/01/2013
31/12/2013
9000
19
00612
BP. MELATI
-87906111
16310
DR M FUAD
01/01/2013
31/12/2013
7000
20
00574
BP. OLYMPIC
-0251-656639 16360
OLYMPIC GROUP
01/01/2013
31/12/2013
10500
21
02987
16310
DR DWI MARHENI
01/01/2013
31/12/2013
7000
22
06474
DR SITI ROBIAH M
16640
DR SITI ROBIAH M
01/01/2013
31/12/2013
7000
23
06132
DR SUMANDI
16310
DR SUMANDI
01/01/2012
31/12/2012
7000
24
06131
DR TRESNAWULAN
16650
DR TRESNAWULAN
01/01/2013
31/12/2013
7000
01/01/2013
31/12/2013
7000
16310
RI244010
v
v
7000
PKR102001
Halaman :
Tanggal :
91/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
25
06071
16310
26
00604
16310
27
00610
-0251-4299467 16310
28
00594
-8756789
16310
29
06035
16310
30
06475
16630
31
04070
DRG MELLYAWATI
32
07849
33
06333
34
05689
35
HARI BUKA
PPK II
S
RS
APT
DR TRIWANDHA ELAN
NO IKS
KAMIS, JUM'AT,
SABTU
POLA PEMBIAYAAN
JAM BUKA
JUMLAH
TTG
I,SHIFT II)
01/01/2013
31/12/2013
7000
01/01/2013
31/12/2013
7000
01/01/2013
31/12/2013
7000
01/01/2013
31/12/2013
7000
DRG MAGDALENA H
01/01/2013
31/12/2013
7000
16310
DRG MELLYAWATI
01/01/2013
31/12/2013
15000
16310
DRG RETNO
01/04/2012
31/12/2012
16610
DRG RIRIT
01/01/2013
31/12/2013
10000
DRG SHIRLEY
16310
DRG SHIRLEY
01/01/2013
31/12/2013
15000
07926
16350
ETI SUNARTI
01/01/2013
31/12/2013
14000
36
07925
16310
01/01/2013
31/12/2013
7000
37
07541
KLINIK ASSALAM
021-8753724
16310
021-8753724
01/01/2013
31/12/2013
7000
38
03726
-0251-240737 16310
01/01/2013
31/12/2013
9400
39
07673
16310
01/01/2013
31/12/2013
7000
40
07674
KLINIK DR ROSALINA
16310
DR ROSALINA
01/01/2013
31/12/2013
7000
41
06331
16640
01/01/2013
31/12/2013
7000
42
04460
KLINIK INSANI
-02518753556 16310
01/01/2013
31/12/2013
14100
43
06034
KLINIK INSANI 2
DR KORNADI
01/01/2013
31/12/2013
7000
44
00608
KP MUHARA CITEUREUP
-021-8754902 16310
-8752544
PT INTI A K
01/01/2009
31/12/2009
7000
45
07390
KLINIK MAEDENA
16310
DR NINA RATNA
01/01/2013
31/12/2013
7000
46
02985
KLINIK MAHASTA
-8753687
16310
DRS DANNI
01/01/2013
31/12/2013
20000
47
06986
16620
DR MARIA W
01/01/2013
31/12/2013
7000
48
07174
0251-8658811 16810
JL RAYA CIBULUH RUKO NO 9 SIMPANG POMAD ;
JL ACHMAD SOBANA/ BANGBARUNG NO
77 BANTARJATI ; JL PERUM TMN KENARI RUKO BLOK E3 NO 4
TANAH BARU ; JL MAYOR OKING NO 510 CIBINONG BOGOR
DR JUNAIDY FREDY
01/01/2013
31/12/2013
14000
RI244010
16730
DR ELIANA NAPITUPULU
15000
PKR102001
Halaman :
Tanggal :
92/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
01/01/2013
31/12/2013
14000
01/01/2013
31/12/2013
14000
01/01/2013
31/12/2013
14000
DR EDRIZAL ANIS
01/01/2013
31/12/2013
20100
DR RIANA ROCHMAWATI
01/01/2013
31/12/2013
7000
16310
DR EKA
01/01/2013
31/12/2013
7000
16310
DR ROSA
01/01/2013
31/12/2013
16000
16310
DRG DENTI
01/01/2013
31/12/2013
15000
16310
DR HANDY WIJAYA
01/01/2013
31/12/2013
7000
06984
16620
DRG MINARTI
01/01/2013
31/12/2013
15000
59
06985
0251-8320459 16370
DR OKI KURNIAWAN
01/01/2013
31/12/2013
7000
60
07391
16310
DR YANTI
01/01/2012
31/12/2012
7000
61
07180
RB AULIA MEDIKA
021-87902900 16810
SUSINAH HARUN
01/01/2012
31/12/2012
7000
62
05481
RB BUNDA MULIA
16310
01/01/2012
31/12/2012
7000
63
06332
RB HARAPAN IBU
16640
01/01/2012
31/12/2012
7000
64
06133
RB INSANI
JL PAHLAWAN NO 73 CITEUREUP
16310
DR KORNADI
01/01/2012
31/12/2012
7000
65
06134
RB MAMA
16360
AMBARIANI
01/01/2012
31/12/2012
7000
66
04458
16310
A.ROHIM HASIBUAN
01/01/2013
31/12/2013
67
04459
16310
68
06473
16640
69
00611
-0251-257648 16310
70
00576
-0251-345222 16310
-0251-344609
71
90579
RSUD. CIBINONG
021-8753487
16310
72
07675
RB NURDIN WAHID
JL HM ASHARI NO 22 CIBINONG
16310
DR EKA
73
07177
RB PELITA SEHAT
0251-8658811 16310
DR JUNAIDY
49
07846
16310
DR JUNAIDY FREDY
50
07847
16310
DR JUNAIDY FREDY
51
07848
0251-8664767 16310
DR JUNAIDY FREDY
52
05567
16310
53
07178
16310
54
07307
55
07844
56
07850
57
07927
58
7000
01/01/2013
31/12/2013
7000
01/01/2013
31/12/2013
7000
01/01/2012
31/12/2012
7000
01/01/2012
31/12/2012
10000
01/01/2012
31/12/2012
7000
01/01/2012
31/12/2012
7000
v
v
VERA
7000
021-8752463
RI244010
PKR102001
Halaman :
Tanggal :
93/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
01/01/2012
31/12/2012
10000
01/01/2012
31/12/2012
10000
01/01/2012
31/12/2012
7000
0251-8312292 16310
0251-8312235
01/01/2012
31/12/2012
10000
-0251-324080 16310
01/01/2012
31/12/2012
10000
16310
DRG HERMAN
01/07/2012
31/12/2012
10000
07539
RSIA ANNISA
16310
DR YUDHY ISKANDAR
01/01/2012
31/12/2012
7000
81
07672
16310
DEDDY
01/01/2012
31/12/2012
10000
82
07851
RSIA MELANIA
16310
DR OKTAVIA NURDIANI
01/04/2012
31/12/2012
10000
83
04066
-0251-327405 16310
01/01/2012
31/12/2012
7000
84
06135
16310
DR NOVIA MIRALIA
01/01/2012
31/12/2012
7000
85
07930
16610
01/06/2012
31/12/2012
10000
86
04447
APOTEK CIBULUH
0251-661946
16310
-661947
HJ IYAN ROHYANI
01/01/2012
31/12/2012
7000
87
06476
APOTEK INSANI
JL PAHLAWAN CITEEUREUP
16310
DR KORNADI
01/01/2012
31/12/2012
7000
88
06372
16630
01/01/2011
31/12/2011
7000
89
03728
APOTEK SEHAT
-0251-332845 16310
01/01/2012
31/12/2012
7000
90
06136
16310
DR SUMANDI
01/01/2011
31/12/2011
7000
91
07017
APOTEK YASA
JL DR SEMERU NO 84 BOGOR
16630
01/01/2012
31/12/2012
10000
92
03727
APOTIK HUSADA
16310
PER/40/092006
01/09/2006
31/08/2007
7000
93
04448
-87900909
16310
01/01/2011
31/12/2011
7000
94
04068
-0251-335905
7000
95
04069
-0251-243212
7000
96
04067
7000
97
00588
16310
98
04455
JL PAJAJARAN 80 BOGOR
16310
99
00585
BOGOR OPTIKAL
16310
HJ WISNI TAHER
100
07929
DANIA OPTICAL
16310
101
05568
INDONESIA OPTIKAL
0251-327319
16310
102
00583
OPTIK CIBULUH
16310
103
00586
BOGOR OPTIKAL
74
07676
RS BINA HUSADA
021-87911000 16951
75
96033
76
07485
RS ISLAM BOGOR
0251-8316822 16310
77
07305
RS KARYA BHAKTI
JL DR SUMERU NO 120
78
93730
RS PMI BOGOR
79
07306
80
RI244010
16310
DR HARSONO
DR HIDAYAT WIJAYA
-0251-323002
01/01/2012
31/12/2012
7000
01/01/2012
31/12/2012
7000
01/01/2012
31/12/2012
7000
E DEDDY SYAMSUDIN
01/06/2012
31/12/2012
10000
GUSTINI TAHER
01/06/2012
31/12/2012
7000
HJ IYAN ROHYANI
01/01/2012
31/12/2012
7000
7000
PKR102001
Halaman :
Tanggal :
94/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
104
04453
BOGOR OPTIKAL
-0251-379323
-8751179
7000
105
00587
BOGOR OPTIKAL
7000
106
04452
OPTIK CIBULUH
-0251-661946
-661947
7000
107
04454
JL IR JUANDA NO. 30
-0251-331992
7000
108
00579
RSD CIBINONG
16310
109
16310
110
06033
16310
111
07305
16310
112
03730
RS PMI BOGOR
JL PAJAJARAN NO 80
16310
113
07306
16310
RI244010
01/01/2012
31/12/2012
10000
01/01/2012
31/12/2012
10000
01/01/2012
31/12/2012
10000
01/01/2012
31/12/2012
10000
01/01/2012
31/12/2012
01/01/2012
31/12/2012
v
DR HARSONO
10000
PKR102001
Halaman :
Tanggal :
95/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/052/072012
01/08/2012
31/07/2013
7000
PER/052/072012
01/08/2012
31/07/2013
7000
PER/012/012013
01/01/2013
31/12/2013
7000
PER/013/012013
01/01/2013
31/12/2013
4000
45163
PER/052/072012
01/08/2012
31/07/2013
4000
45156
PER/012/012013
01/01/2013
31/12/2013
7000
PKM CIGASONG
45452
PER/013/012013
01/01/2013
31/12/2013
4000
00678
PKM CIKIJING
45466
PER/013/012013
01/01/2013
31/12/2013
7000
00633
PKM CILEDUG
-0231-661091 45152
PER/052/072012
01/08/2012
31/07/2013
7000
10
00680
-0231-614403 45553
PER/010/012013
01/01/2013
31/12/2013
7000
11
00637
PKM CIWARINGIN
45155
PER/052/072012
01/08/2012
31/07/2013
7000
12
00685
PKM DAWUAN/KASOKANDEL
-0233-883490 45453
PER/013/012013
01/01/2013
31/12/2013
7000
13
00628
PKM DERAJAT
-0231-210180 45134
PER/011/012013
01/01/2013
31/12/2013
7000
14
06489
PKM DUKUPUNTANG
45154
PER/052/072012
01/08/2012
31/07/2013
4000
15
00632
PKM GEBANG
45155
SENIN
PER/052/072012
01/08/2012
31/07/2013
7000
16
00638
PKM GEGESIK
-0231-357788 45161
PER/052/072012
01/08/2012
31/07/2013
7000
17
00623
PKM GUNUNGJATI
45151
PER/052/072012
01/08/2012
31/07/2013
7000
18
00666
PKM GUNUNGSARI
-0231-207154 45132
PER/011/012013
01/01/2013
31/12/2013
7000
19
00651
PKM HAURGEULIS
-0234-741593 45253
PER/012/012013
01/01/2013
31/12/2013
7000
20
00668
PKM JAGASATRU
-0231-230058 45134
PER/011/012013
01/01/2013
31/12/2013
7000
21
00672
PKM JATIBARANG
-0234-351284 45153
PER/012/012013
01/01/2013
31/12/2013
7000
22
06486
PKM JATITUJUH
45458
PER/013/012013
01/01/2013
31/12/2013
4000
23
00677
PKM JATIWANGI
-0233-881030
PER/013/012013
01/01/2013
31/12/2013
7000
24
00674
PKM JUNTINYUAT
-0234-428136 45256
PER/012/012013
01/01/2013
31/12/2013
7000
25
00624
PKM KALIJAGA
-0231-481783 45132
PER/011/012013
01/01/2013
31/12/2013
7000
26
00625
PKM KALITANJUNG
-0231-483883 45132
PER/011/012013
01/01/2013
31/12/2013
7000
27
00653
-0234-505627 45257
PER/012/012013
01/01/2013
31/12/2013
7000
28
00687
PKM KARANGAMPEL
-0234-484092 45156
PER/012/012013
01/01/2013
31/12/2013
7000
02747
PKM SUMBER
45163
00635
PKM ASTANAJAPURA
-0231-635390 45153
00642
PKM BALONGAN
-0234-428035 45255
06482
PKM BANTARUJEG
45464
07458
00646
PKM BOJONGSARI
06487
RI244010
PKR102001
Halaman :
Tanggal :
96/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/052/072012
01/08/2012
31/07/2013
7000
PER/011/012013
01/01/2013
31/12/2013
7000
PER/013/012013
01/01/2013
31/12/2013
4000
PER/012/012013
01/01/2013
31/12/2013
7000
45252
PER/012/012013
01/01/2013
31/12/2013
7000
-0231-202601 45132
PER/011/012013
01/01/2013
31/12/2013
7000
45262
PER/012/012013
01/01/2013
31/12/2013
7000
00659
PKM KLANGENAN
-0231-431363 45171
PER/052/072012
01/08/2012
31/07/2013
7000
37
00682
PKM KUNINGAN
45552
PER/008/012013
01/01/2013
31/12/2013
7000
38
00676
45452
PER/013/012013
01/01/2013
31/12/2013
7000
39
00622
PKM LARANGAN
-0231-488132 45132
PER/011/012013
01/01/2013
31/12/2013
7000
40
00679
-0233-510469
PER/013/012013
01/01/2013
31/12/2013
7000
41
06554
PKM LIGUNG
45456
PER/013/012013
01/01/2013
31/12/2013
4000
42
00656
PKM LOHBENER
45263
PER/012/012013
01/01/2013
31/12/2013
7000
43
00654
PKM LOSARANG
-0234-505026 45263
PER/012/012013
01/01/2013
31/12/2013
7000
44
00649
PKM LOSARI
-0231-661474 45181
PER/052/072012
01/08/2012
31/07/2013
7000
45
04363
PKM LURAH
45187
PER/052/072012
01/08/2012
31/07/2013
7000
46
06484
PKM MAJA
45461
PER/013/012013
01/01/2013
31/12/2013
4000
47
00675
-0233-281857
PER/013/012013
01/01/2013
31/12/2013
7000
48
00648
PKM MARGADADI
-0234-271922 45271
PER/012/012013
01/01/2013
31/12/2013
7000
49
03705
-0232-878392 45561
PER/009/012013
01/01/2013
31/12/2013
7000
50
00636
PKM MUNDU
-0231-510240 45154
PER/052/072012
01/08/2012
31/07/2013
7000
51
00686
PKM MUNJUL
-0233-282093 45453
PER/013/012013
01/01/2013
31/12/2013
7000
52
00658
PKM PALIMANAN
-0231-341279 45172
PER/052/072012
01/08/2012
31/07/2013
7000
53
04362
PKM PANGKALAN
45192
PER/052/072012
01/08/2012
31/07/2013
7000
54
00639
PKM PANGURAGAN
45163
PER/052/072012
01/08/2012
31/07/2013
7000
55
07312
PKM PATROL
45252
PER/012/012013
01/01/2013
31/12/2013
4000
56
00631
PKM PEKIRINGAN/KESAMBI
-0231-209933 45134
PER/011/012013
01/01/2013
31/12/2013
7000
57
00627
45134
PER/011/012013
01/01/2013
31/12/2013
7000
29
00663
PKM KEDAWUNG
-0231-487795 45162
30
00670
PKM KEJAKSAN
-0231-244128 45134
31
06488
PKM KERTAJATI
45457
32
00673
PKM KERTASMAYA
-0234-352228 45261
33
00655
PKM KERTAWINANGUN
34
00671
PKM KESUNEAN
35
00657
36
RI244010
PKR102001
Halaman :
Tanggal :
97/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
58
00662
PKM PLERED
-0231-322311 45182
PER/052/072012
01/08/2012
31/07/2013
7000
59
00660
-0231-321632 45187
PER/052/072012
01/08/2012
31/07/2013
7000
60
00644
45165
PER/012/012013
01/01/2013
31/12/2013
7000
61
00683
PKM RAJAGALUH
-0233-510584
PER/013/012013
01/01/2013
31/12/2013
7000
62
00641
PKM SINDANG
-0234-271513 45253
PER/012/012013
01/01/2013
31/12/2013
7000
63
00634
-0231-635386 45153
PER/052/072012
01/08/2012
31/07/2013
7000
64
06485
PKM SUKAHAJI
45471
PER/013/012013
01/01/2013
31/12/2013
4000
65
00652
PKM SUKRA
-0234-610159 45262
PER/012/012013
01/01/2013
31/12/2013
7000
66
00684
PKM SUMBERJAYA
PRAPATAN MAJALENGKA
-0233-510446
PER/013/012013
01/01/2013
31/12/2013
7000
67
00630
PKM SUNYARAGI
-0231-482543 45132
PER/011/012013
01/01/2013
31/12/2013
7000
68
00664
PKM SURANENGGALA
45167
PER/052/072012
01/08/2012
31/07/2013
7000
69
06483
PKM TALAGA
45463
PER/013/012013
01/01/2013
31/12/2013
4000
70
00681
PKM TALUN
45165
PER/052/072012
01/08/2012
31/07/2013
7000
71
00640
45283
PER/052/072012
01/08/2012
31/07/2013
7000
72
00650
PKM WIDASARI
-0234-351629 45271
PER/012/012013
01/01/2013
31/12/2013
7000
73
06649
45151
4000
74
06851
45252
75
06800
45252
76
06480
45455
77
06481
45151
78
06073
45132
79
04833
BP AUREL
-08122337688 45254
80
03433
BP DHARMA HUSADHA
-08122200796 45132
81
05869
BP KOPKAR SEJAHTERA
82
04604
BP PMI
83
04198
RI244010
ROHADI ACHMAD
PER/091/102012
01/11/2012
31/05/2013
PER/062/082012
01/08/2012
31/07/2013
4000
PER/032/032012
01/03/2012
28/02/2013
4000
SRI RAHAYU P
PER/082/PKS-PPKI/JPKCRB/122009
01/01/2010
31/12/2010
4000
31/12/2010
4000
PER/097/112012
01/11/2012
31/10/2013
4000
PER/029/022012
01/02/2012
31/01/2013
7000
PER/004/012013
01/01/2013
31/12/2013
7000
DR DEDEN
45151
PER/002/082008
01/08/2008
31/07/2009
7000
-NULL
45155
PER/043/042012
01/05/2012
30/04/2013
7000
45252
PER/048/072012
01/07/2012
30/06/2013
7000
PKR102001
Halaman :
Tanggal :
98/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/021/012013
01/01/2013
31/12/2013
4000
PER/005/012013
01/01/2013
31/12/2013
7000
PER/003/012013
01/01/2013
31/12/2013
14000
PER/095/102012
01/10/2012
30/09/2013
4000
PER/101/112012
01/11/2012
31/10/2013
7000
PER/045/052012
01/05/2012
30/04/2013
7000
PER/037/032012
01/04/2012
31/03/2013
7000
45252
PER/047/072012
01/07/2012
30/06/2013
3000
0812-2224424 45552
PER/063/062012
01/06/2012
31/05/2013
DR YENI NURAINI
45154
PER/049/072012
01/08/2012
31/07/2013
7000
06287
45552
PER/036/032012
01/03/2012
28/02/2013
4000
95
07377
45151
PER/090/102012
01/11/2012
31/10/2013
4000
96
06285
45552
PER/031/032012
01/03/2012
28/02/2013
4000
97
05109
45151
DR FUAD ABDULLAH
PER/059/082012
01/09/2012
31/08/2013
7000
98
07827
45132
PER/024/012012
01/02/2012
31/01/2013
99
06434
45452
31/12/2010
100
06074
45255
PER/060/082012
01/09/2012
31/08/2013
101
00647
-0234-276055 45263
PER/006/012013
01/01/2013
31/12/2013
7000
102
06490
45255
PER/025/022012
01/02/2012
31/01/2013
4000
103
07457
DR.H.EDI SUSANTO
45153
PER/064/082012
01/08/2012
31/07/2013
104
07454
45452
PER/062/102012
01/08/2012
31/07/2013
105
07576
45452
PER/105/112012
01/11/2012
31/10/2013
106
03890
45151
107
04186
45252
108
03891
DRG MAHMUDAH
45285
84
06491
JALAN SYEKH DATUL KAHFI NO.25 RT.08 RW.02 DESA WERU LOR KEC.WERU KABUPATEN CIREBON
85
00643
86
03434
87
45151
-0231-480703 45151
DR ALINDA NURUL A
JL SISINGAMANGARAJA NO 58 A CIREBON
-0816644581
45134
05875
DR BAMBANG SUMARDI
JL URIP SUMOHARJO
45162
88
06983
DR FACHRI OEMRAN
-081222153730 45132
DR FACHRI OEMRAN
89
07311
DR HADI SUDIANA
DR HADI SUDIANA
90
05877
45132
91
04185
DR LISFAYENI
92
07376
DR SUPARDI
93
05046
94
RI244010
AGUNG SETIAWAN
DR SUPARDI
7000
4000
4000
v
v
4000
4000
4000
v
v
4000
PER/001/012013
01/01/2013
31/12/2013
7000
PER/046/062012
01/06/2012
31/05/2013
10000
PER/002/012013
01/01/2013
31/12/2013
7000
PKR102001
Halaman :
Tanggal :
99/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
109
07337
-081806990684 45132
110
07455
DRG.AGUS WIBOWO
45265
111
07574
DRG.H.YONO SOEPRIYONO
45151
112
06289
0231-236685
45132
113
06633
DRG.NOVITA AYRISARI
114
06075
115
06564
116
06565
117
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/055/062012
01/06/2012
31/05/2013
PER/065/082012
01/08/2012
31/07/2013
7000
PER/104/112012
01/11/2012
31/10/2013
7000
0231-486140
PER/058/082012
01/09/2012
31/08/2013
45452
PER/042/042012
01/05/2012
30/04/2013
45153
PER/102/122012
01/12/2012
28/02/2013
45252
PER/033/032012
01/03/2012
28/02/2013
4000
45452
PER/034/032012
01/03/2012
28/02/2013
4000
07456
45262
PER/049/082011
01/08/2011
31/07/2012
7000
118
05416
0231-8330102 45151
PER/038/032012
01/04/2012
31/03/2013
7000
119
06632
45252
7000
120
06837
RB RAJAWALI
0231-202367
45132
121
05878
RB UMMI RAHMAH
45134
122
05900
RSB MUHAMMADIYAH
45132
123
03435
BP SEJAHTERA
-08122052533
124
04418
DR H MADAYAN HARAHAP
125
04108
126
03436
RS TENTARA CIREMAI
127
04795
128
DRG.H.YONO SOEPRIYONO
10000
v
v
7000
4000
PER/041/042012
01/05/2012
30/04/2013
PER/087/112009
01/12/2009
30/11/2011
4000
PER/075/102011
01/10/2011
30/09/2012
4000
PER/001/112008
01/11/2008
31/10/2009
4000
7000
PER/003/082007
01/08/2007
31/07/2008
PER/040/032012
01/04/2012
31/03/2013
7000
PER/001/052005
02/05/2005
02/05/2006
7000
JL KESAMBI NO 237
-0231-201861 45151
-0231-231625
0234-507878
0234-507877
00694
RSUD 45 KUNINGAN
-0232-874701 45552
-0232-871885
129
00689
RSUD ARJAWINANGUN
-0231-359090 45153
130
00692
0233-961003
131
00688
132
00691
RSUD INDRAMAYU
133
06085
134
135
7000
PER/017/012012
01/01/2012
31/12/2012
PER/014/012012
01/01/2012
31/12/2012
PER/061/102011
01/11/2011
31/05/2012
7000
PER/057/072009
01/07/2009
31/12/2009
7000
0233-660282
PER/067/11.2011
01/12/2011
30/11/2012
-0231-206330 45132
PER/016/012012
01/01/2012
31/12/2012
-0234-272655 45252
-0234-275330
PER/077/122010
01/01/2011
31/12/2011
RSUD MAJALENGKA
0233-281043
45452
PER/027/022012
01/02/2012
31/01/2013
06555
45257
PER/028/022012
01/01/2012
31/12/2012
00690
RSUD WALED
-0231-661126 45151
-0231-661126
PER/076/112011
01/11/2011
31/10/2012
RI244010
45253
45456
POLRI
7000
7000
PKR102001
Halaman :
Tanggal :
100/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
136
07826
0234- 275013
45252
0234-275112
137
05415
0231-341079
45151
138
05881
RS WIJAYA KUSUMA
45552
139
06634
45132
140
04200
RS MITRA PLUMBON
141
05639
JL.JEND.A.YANI 219 D
45262
142
05868
APOTEK AUREL
0234-508223
45252
143
05899
APOTEK MANFA'AT
45552
144
04796
APOTIK FAMILY
0232-875566
45554
0232-871196
145
04187
146
03447
JL KESAMBI NO 141
-0231-202813
147
00697
148
00695
149
03892
150
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
31/03/2013
PER/039/032012
PER/026/022012
01/02/2012
31/01/2013
PER/059/102011
01/10/2011
30/09/2012
PER/044/042012
01/05/2012
30/04/2013
PER/018/012012
01/01/2012
31/12/2012
PER
01/07/2010
/001/ADDENDUM/072010
31/08/2010
31/07/2010
PER/056/092010
01/11/2010
31/10/2011
PER/021/012007
01/01/2007
31/12/2007
PER/005/062008
01/06/2008
31/05/2009
7000
PER/100/112012
01/11/2012
31/10/2013
7000
-0231-230286
PER/073/112011
01/11/2011
31/10/2012
7000
-0231-208954
-0231-208195
PER/100/112012
01/11/2012
31/10/2013
7000
PER/003/072007
02/07/2007
30/06/2008
7000
06759
45132
151
06241
45132
152
00698
153
07135
154
03706
JL BAHAGIA CIREBON
155
04602
156
PT SINARYA BERSAUDARA
7000
PER/051/072012
01/07/2012
30/06/2013
PER/050/072012
01/07/2012
30/06/2013
-0231-201183 45152
PER/019/012012
01/01/2012
31/12/2012
45452
PER/008/022011
01/03/2011
28/02/2012
-0231-208103
PER/082/122010
01/01/2011
31/12/2011
7000
-NULL
PER/003/072006
01/07/2006
30/06/2007
7000
45252
PER/103/112012
01/11/2012
31/10/2013
157
JL KESAMBI NO.237
45132
PER/022/012013
01/01/2013
31/12/2013
158
45154
PER/056/072012
01/07/2012
30/06/2013
159
JL.MARTADINATA NO.172
45552
PER/025/012013
01/01/2013
31/12/2013
RI244010
H. OKO MARKONI
7000
7000
PKR102001
Halaman :
Tanggal :
101/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/34/012013
01/01/2013
31/12/2013
7000
PER/34/012013
01/01/2013
31/12/2013
7000
PER/34/012013
01/01/2013
31/12/2013
7000
PER/34/012013
01/01/2013
31/12/2013
7000
PER/34/012013
01/01/2013
31/12/2013
7000
15211
PER/34/012013
01/01/2013
31/12/2013
7000
JL BERINGIN TANGERANG
021-55796003 15211
PER/34/012013
01/01/2013
31/12/2013
7000
PKM KUNCIRAN
021-7327988
15211
PER/34/012013
01/01/2013
31/12/2013
7000
02507
021-73445349 15211
PER/34/012013
01/01/2013
31/12/2013
7000
10
02499
021-55794468 15211
PER/34/012013
01/01/2013
31/12/2013
7000
11
02509
PKM PANUNGGANGAN/CIPETE
021-70283936 15211
PER/34/012013
01/01/2013
31/12/2013
7000
12
02508
021-55771587 15211
PER/34/012013
01/01/2013
31/12/2013
7000
13
02498
PKM SUKASARI
021-55792631 15211
PER/34/012013
01/01/2013
31/12/2013
7000
14
04963
PUSKESMAS BENDA
021-9101041
15211
PER/34/012013
01/01/2013
31/12/2013
7000
15
04962
PUSKESMAS BUGEL
15211
PER/34/012013
01/01/2013
31/12/2013
7000
16
07339
PUSKESMAS CIPADU
021-44652666 15211
PER/34/012013
01/01/2013
31/12/2013
3500
17
04967
PUSKESMAS GEMBOR
021-5926553
15211
PER/34/012013
01/01/2013
31/12/2013
7000
18
07342
PUSKESMAS GONDRONG
021-45656336 15211
PER/34/012013
01/01/2013
31/12/2013
3500
19
04964
021-55796181 15211
PER/34/012013
01/01/2013
31/12/2013
7000
20
07340
PUSKESMAS KARANGTENGAH
021-7330387
15211
PER/34/012013
01/01/2013
31/12/2013
3500
21
04968
021-5500359
15211
PER/34/012013
01/01/2013
31/12/2013
7000
22
07343
PUSKESMAS KETAPANG
021-54373354 15211
PER/34/012013
01/01/2013
31/12/2013
3500
23
04969
PUSKESMAS NEGLASARI
021-5518911
15211
PER/34/012013
01/01/2013
31/12/2013
7000
24
04966
021-5526029
15211
PER/34/012013
01/01/2013
31/12/2013
7000
25
07341
PUSKESMAS PEDURENAN
021-7321020
15211
PER/34/012013
01/01/2013
31/12/2013
3500
02505
021-5912802
15211
02502
021-5584508
15211
05204
PKM CIBODASARI
021-5917986
15211
02506
PKM CILEDUG
021-7327941
15211
02500
PKM CIPONDOH
021-5541919
15211
02503
PKM JATIUWUNG
021-5904138
04297
02501
RI244010
PKR102001
Halaman :
Tanggal :
102/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/34/012013
01/01/2013
31/12/2013
7000
PER/34/012013
01/01/2013
31/12/2013
7000
PER/34/012013
01/01/2013
31/12/2013
7000
PER/34/012013
01/01/2013
31/12/2013
7000
PER/34/012013
01/01/2013
31/12/2013
7000
15211
PER/01/012013
01/01/2013
31/12/2013
14000
15211
HUDNI, SKM
PER/14/012013
01/01/2013
31/03/2013
14000
021-46708434 15211
PER/13/012013
01/01/2013
31/12/2013
7000
15211
-5445855
PER/23/012013
01/01/2013
31/12/2013
7000
021-5518867
15211
DR. HANDAYA D
PER/22/012013
01/01/2013
31/12/2013
14000
15211
BIDAN SANI
PER/43/012013
01/01/2013
31/12/2013
14000
15211
DR DIDI
PER/44/012013
01/01/2013
31/12/2013
14000
00718
021-55798985 15211
PER/20/012013
01/01/2013
31/12/2013
14000
39
05432
15211
PER/40/012013
01/01/2013
31/12/2013
14000
40
05125
021-
15211
SUNARTO
PER/38/012013
01/01/2013
31/12/2013
14000
41
05615
TANGERANG
021-5502676
15211
021-5502680
DR. DJUNAIDY R S
PER/45/012013
01/01/2013
31/12/2013
14000
42
07823
021-54205986 15211
TITI SURYATI
PER/55/012013
01/01/2013
31/12/2013
14000
43
02490
KLINIK MELATI
15211
HUDNI, SKM
PER/37/012013
01/01/2013
31/03/2013
14000
44
05431
JALAN RAYA PAKUHAJI DESA SARAKAN RT 01/01 PISANGAN 021SIMPANG 4 KECAMATAN SEPATAN KABUPATEN TANGERANG
15211
PER/36/012013
01/01/2013
31/12/2013
14000
45
06353
KLINIK PRADHANA
021-54380703 15211
PER/49/012013
01/01/2013
31/12/2013
14000
46
07344
KLINIK PRASHANTI
021-5525365
021-5525365
PER/52/012013
01/01/2013
31/12/2013
14000
47
06936
021-33791202 15211
PER/08/012013
01/01/2013
31/12/2013
14000
48
00704
021-5528883
15211
PER/09/012013
01/01/2013
31/12/2013
14000
49
00714
PER/04/012013
01/01/2013
31/12/2013
14000
26
04971
021-70209013 15211
27
04970
021-70942811 15211
28
04961
15211
29
04965
PUSKESMAS TAJUR
021-7321015
15211
30
04960
021-55799185 15211
31
03533
KLINIK BELINDA
32
03633
-9
33
00708
34
00710
35
01300
36
04045
37
04044
38
RI244010
15211
PKR102001
Halaman :
Tanggal :
103/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/12/012013
01/01/2013
31/12/2013
14000
PER/02/012013
01/01/2013
31/12/2013
14000
PER/03/012013
01/01/2013
31/12/2013
14000
PER/53/012013
01/01/2013
31/12/2013
14000
PER/42/012013
01/01/2013
31/12/2013
28000
PER/10/012013
01/01/2013
31/12/2013
14000
PER/18/012013
01/01/2013
31/12/2013
14000
DR MOHAMAD
KHAERUMAYANSYAH
PER/54/012013
01/01/2013
31/12/2013
14000
DR M AGUS SALEH
PER/01/012012
01/01/2012
31/12/2012
14000
15211
PER/10/012012
01/01/2012
31/12/2012
14000
07824
RS TK IV DAAN MOGOT
021-5523551
15211
021-5535754
PER/56/042012
01/04/2012
31/12/2012
61
02491
RSU TANGERANG
-55770830
15211
PER/26/112012
01/11/2012
31/12/2012
62
03917
RS BHAKTI ASIH
-7305662
15211
PER/16/112012
01/11/2012
31/12/2012
63
06525
RS MITRA HUSADA
021-55932610 15211
PER/49/032012
01/03/2012
28/02/2013
64
06639
RS USADA INSANI
021- 5521270
15211
PER/51/052012
01/05/2012
31/12/2012
65
8100
021-5470263
15157
PER/60/112012
01/11/2012
31/12/2012
66
06296
021-7322443
15211
021-7310721
PER/48/092012
01/09/2012
31/12/2012
67
02493
JL A. YANI NO 31 TANGERANG
021-5527039
15211
021-5527039
PER/28/112012
01/11/2012
31/12/2012
68
03913
-55770830
15211
PER/26/112012
01/11/2012
31/12/2012
69
04382
APOTEK META
-5522007
15211
PER/17/112012
01/11/2012
31/12/2012
70
02494
OPTIK JOY
JL KI SAMAUN NO 38 TANGERANG
-5521632
15211
PER/30/112012
01/11/2012
31/12/2012
71
02495
OPTIK RIK-RIK
-55761496
15211
PER/31/112012
01/11/2012
31/12/2012
72
021-55780888 15211
PER/15/012012
01/01/2012
31/12/2012
50
00713
021-7323207
15211
51
03534
021-54213590 15211
KUNADI, SE
52
00705
021-5532915
15211
53
07345
15211
54
04112
021-5913555
15221
DRG. LINDAWATI
55
04383
RB 1 METTA MEDIKA
JLBOURAQ NO1(JL LIO BARU NO1)KEL BATU JAYA KEC BATU 021-5522007
CEPER TG
15211
56
03693
RB 1 PAV DR HARYADI
021-5849009
15211
57
07822
15211
58
07137
59
05012
60
RI244010
v
v
v
v
7000
7000
PKR102001
Halaman :
Tanggal :
104/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/001/012013
01/01/2013
31/12/2013
7000
PER/001/012013
01/01/2013
31/12/2013
7000
PER/003/012013
01/01/2013
31/12/2013
7000
PER/001/012013
01/01/2013
31/12/2013
7000
PER/003/012013
01/01/2013
31/12/2013
7000
PER/001/012013
01/01/2013
31/12/2013
7000
PER/003/012013
01/01/2013
31/12/2013
7000
PER/001/012013
01/01/2013
31/12/2013
7000
PER/001/012013
01/01/2013
31/12/2013
7000
PER/001/012013
01/01/2013
31/12/2013
7000
PER/001/012013
01/01/2013
31/12/2013
7000
PER/010/012013
01/01/2013
31/12/2013
28000
0254-284338
PER/030/012013
01/01/2013
31/12/2013
14000
0252-5282828 42164
PER/028/012013
01/01/2013
31/12/2013
14000
0254-934028
42161
PER/005/012013
01/01/2013
31/12/2013
8000
0813-16224653 42454
PER/058/012013
01/01/2013
31/12/2013
7000
07182
DR.BAMBA YURNADI
42423
PER/041/012013
01/01/2013
31/12/2013
8000
18
00739
0254-600628
42161
PER/021/012013
01/01/2013
31/12/2013
14000
19
02751
KLINIK AL FALAH
-08129958716 42161
PER/014/012013
01/01/2013
31/12/2013
14000
20
04910
42167
DR. H. A HASANUDIN
PER/024/012013
01/01/2013
31/12/2013
14000
21
08046
-087808192103 42186
PER/052/012013
01/01/2013
31/12/2013
7000
22
02749
0252-202533
42163
PER/018/012012
01/01/2012
31/12/2012
14000
23
05626
42161
PER/004/012013
01/01/2013
31/12/2013
8000
24
08151
KLINIK BOUGENVILLE
0253-202746
42213
01/01/2013
31/12/2013
7000
00735
PKM CARITA
0253-802354
42165
00752
PKM LABUAN
0253-801009
42165
06904
PUSKESMAS BAYAH
16411
06919
PUSKESMAS CIBALIUNG
42263
06393
-081911194959 42394
06921
PUSKESMAS CIKEUSIK
JL.RAYA MALIMPING
42261
06394
-081318801289 42391
03458
PUSKESMAS PANIMBANG
42164
03457
PUSKESMAS PEGADUNGAN
-08128033701 42185
10
06920
PUSKESMAS SOBANG
JL.RAYA PANIMBANG NO 3
42261
11
03459
PUSKESMAS SUKARATU
42173
12
00741
0254-400554
42164
13
06853
AL-BAROKAH
0254-284338
42161
14
06774
BP. AR-ROHMAN
15
00742
16
08155
17
RI244010
DINKES LEBAK
DINKES LEBAK
PKR102001
Halaman :
Tanggal :
105/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
25
07526
0254-311323
26
08154
27
06502
KLINIK DIFA
28
08045
29
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/044/012013
01/01/2013
31/12/2013
PER/064/012013
01/01/2013
31/12/2013
7000
PER/025/012012
01/10/2012
31/12/2012
7000
PER/053/012013
01/01/2013
31/12/2013
7000
PER/002/012013
01/01/2013
31/12/2013
50000
PER/007/012013
01/01/2013
31/12/2013
14000
PER/059/012013
01/01/2013
31/12/2013
7000
DR. ISNAYATI
PER/050/012013
01/01/2013
31/12/2013
DR.JANA SUNAWATI
PER/017/012013
01/01/2013
31/12/2013
14000
42183
PER/043/012013
01/01/2013
31/12/2013
7000
-087881096000 42185
PER/057/012013
01/01/2013
31/12/2013
7000
KLINIK MEDIKA
0252-5011156 42161
PER/040/012013
01/01/2013
31/12/2013
140000
03476
0254-581720
42164
PER/011/012013
01/01/2013
31/12/2013
14000
38
08157
KLINIK MULTAZAM
08777-2826045 42182
PER/060/012013
01/01/2013
31/12/2013
7000
39
00740
0254-282161
42163
PER/012/012012
01/01/2012
31/12/2012
14000
40
08159
0254-388543
42422
0254-388543
PER/062/012013
01/01/2013
31/12/2013
7000
41
02753
KLINIK RA MEDIKA
0254-574922
42164
PER/009/012013
01/01/2013
31/12/2013
14000
42
07783
0254-257330
42453
PER/049/012012
01/01/2013
31/12/2013
14000
43
03475
0254-388706
42164
PER/008/012013
01/01/2013
31/12/2013
8000
44
02755
KLINIK SURYA
0252-203989
42164
PER/023/012013
01/01/2013
31/12/2013
14000
45
06773
KLINIK TUBAGUS
0254-7001597 42161
PER/029/012013
01/01/2013
31/12/2013
8000
46
07785
0254-257330
42161
PER/047/012013
01/01/2013
31/12/2013
7000
47
08150
0254-2540201 42173
PER/068/012013
01/01/2013
31/12/2013
7000
48
05675
KLINIK&RB.GANDI MEDIKA
PER/019/012013
01/01/2013
31/12/2013
0254-310568
0254-8317010 42441
BD NINIK JOHARIYAH
0253-502161
42262
0253-502160
DIDI MULYADI,SKM.M.KES
42161
YAYASAN PENDIDIKAN
FATAHILLAH
06421
42453
MARLENA HARTATI,AMK
30
05907
42161
31
08156
KLINIK INSANI
0856-1006342 42178
32
07918
0878-78469212 42453
33
06232
KLINIK JANNAH
0254-215654
42161
34
07445
KLINIK JANNAH 2
35
08101
KLINIK KIBIN
36
07143
37
RI244010
42445
42161
RAHMATULLAH SST.FT
7000
28000
PKR102001
Halaman :
Tanggal :
106/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
49
04586
0254-380946
42161
DR.SRI HASTUTI
50
06161
SAHABAT SEHAT
42161
DR.H.RAHMAT FITRIADI,M.KES
(MMR)
51
00744
-0254-376433 42453
52
03481
RSU CILEGON
0254-330461
42453
53
00745
RSU PANDEGLANG
JL KESEHATAN NO 1 PANDEGLANG
0253-201007
42164
54
0745
RSUD PANDEGLANG
55
00743
RSUD SERANG
56
07142
57
07917
58
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/022/012013
01/01/2013
31/12/2013
PER/016/012013
01/01/2013
31/12/2013
8000
PER/036/012013
01/01/2013
31/12/2013
7000
PER/038/092011
01/09/2011
31/08/2013
PER/037/012013
01/01/2013
31/12/2013
42167
IKS/013/012007
01/01/2007
31/12/2007
42164
PER/034/012013
01/01/2013
31/12/2013
0254-281829
42182
0254-281845
PER/039/012012
01/01/2012
31/12/2012
0254-392278
42423
0254-392273
PER/051/012013
01/01/2013
31/12/2013
07646
APOTEK BOUGENVILLE
0253-202746
42251
ARIEF RAKHMAT H, ST
PER/045/012013
01/01/2013
31/12/2013
59
06674
APOTEK GANDI
0254-400139
42161
MARLENA HARTATI
PER/033/012013
01/01/2013
31/12/2013
60
07680
APOTEK JANNAH
0254-280786
42171
PER/046/012013
01/01/2013
31/12/2013
61
03479
0254-200457
42163
PER/031/012013
01/01/2013
31/12/2013
62
07884
0254-222718
42183
PER/048/012013
01/01/2013
31/12/2013
63
05908
NUSA OPTICAL
42453
PER/035/012013
01/01/2013
31/12/2013
64
00749
-0254-201842 41250
PER/032/012012
01/01/2012
31/12/2012
65
0000
RSUD SERANG
0254-200528
0254-200724
IKS/01/022012
08/02/2012
07/02/2013
RI244010
42121
KABUPATEN SERANG
v
v
7000
7000
7000
14000
PKR102001
Halaman :
Tanggal :
107/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/02/012013
01/01/2013
31/12/2013
7000
PER/03/012013
01/01/2013
31/12/2013
7000
PER/03/012013
01/01/2013
31/12/2013
7000
PER/02/012013
01/01/2013
31/12/2013
7000
-0266-240118 43151
PER/01/012013
01/01/2013
31/12/2013
7000
-0266-317307 43151
PER/02/012013
01/01/2013
31/12/2013
7000
PKM CIBADAK
-0266-535712 43151
PER/02/012013
01/01/2013
31/12/2013
7000
00786
PKM CIBAREGBEG
43262
PER/01/012013
01/01/2013
31/12/2013
7000
00791
PKM CIBEBER
-0266-334026 43262
PER/01/012013
01/01/2013
31/12/2013
7000
10
00795
PKM CIBITUNG
43151
PER/02/012013
01/01/2013
31/12/2013
7000
11
00796
PKM CICANTAYAN
43151
PER/02/012013
01/01/2013
31/12/2013
7000
12
00825
PKM CICURUG
-0266-731105 43359
PER/02/012013
01/01/2013
31/12/2013
7000
13
00792
PKM CIDADAP
43185
PER/02/012013
01/01/2013
31/12/2013
7000
14
00813
PKM CIDAHU
43151
PER/02/012013
01/01/2013
31/12/2013
7000
15
00830
PKM CIDOLOG
43151
PER/02/012013
01/01/2013
31/12/2013
7000
16
00832
PKM CIEMAS
43151
PER/02/012013
01/01/2013
31/12/2013
7000
17
00773
PKM CIJAGANG
-0266-321583 43253
PER/01/012013
01/01/2013
31/12/2013
7000
18
00809
PKM CIJANGKAR
43151
PER/02/012013
01/01/2013
31/12/2013
7000
19
00768
PKM CIJEDIL
43252
PER/01/012013
01/01/2013
31/12/2013
7000
20
00817
PKM CIKAKAK
-0266-431875 43151
PER/02/012013
01/01/2013
31/12/2013
7000
21
00774
-0266-322353 43291
PER/01/012013
01/01/2013
31/12/2013
7000
22
00815
PKM CIKEMBAR
-0266-321139 43151
PER/02/012013
01/01/2013
31/12/2013
7000
23
00826
PKM CIKIDANG
43151
PER/02/012013
01/01/2013
31/12/2013
7000
24
00780
PKM CIKONDANG
-0266-321583 43252
PER/01/012013
01/01/2013
31/12/2013
7000
25
00779
PKM CILAKU
-0266-334244 43151
PER/01/012013
01/01/2013
31/12/2013
7000
26
00787
PKM CIPANAS
-0266-519371 43261
PER/01/012013
01/01/2013
31/12/2013
7000
27
00838
-0266-225041 43151
PER/03/012013
01/01/2013
31/12/2013
7000
28
00776
PKM CIPENDAWA
-0266-512136 43253
PER/01/012013
01/01/2013
31/12/2013
7000
29
00782
PKM CIPEUYEUM
-0266-343457 43151
PER/01/012013
01/01/2013
31/12/2013
7000
30
00767
PKM CIRACAP
43151
PER/02/012013
01/01/2013
31/12/2013
7000
00821
43151
00839
PKM BAROS
-0266-221040 43151
00836
PKM BENTENG
-0266-225219 43151
00794
43151
00781
00798
PKM CARINGIN
00804
RI244010
PKR102001
Halaman :
Tanggal :
108/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
31
00783
PKM CIRANJANG
-0266-334244 43282
PER/01/012013
01/01/2013
31/12/2013
7000
32
00822
PKM CISAAT
-0266-221842 43151
PER/02/012013
01/01/2013
31/12/2013
7000
33
00816
PKM CISOLOK
-0266-531512 43151
PER/02/012013
01/01/2013
31/12/2013
7000
34
00784
PKM CUGENANG
-0266-266533 43252
PER/01/012013
01/01/2013
31/12/2013
7000
35
00761
-0266-211414 43151
PER/03/012013
01/01/2013
31/12/2013
7000
36
00835
-0266-215606 43151
PER/02/012013
01/01/2013
31/12/2013
7000
37
00788
PKM GEKBRONG
-0266-260442 43261
PER/01/012013
01/01/2013
31/12/2013
7000
38
00800
43151
PER/02/012013
01/01/2013
31/12/2013
7000
39
00808
-0266-490009 43151
PER/02/012013
01/01/2013
31/12/2013
7000
40
00802
-0266-460003 43151
PER/02/012013
01/01/2013
31/12/2013
7000
41
00793
PKM KABANDUNGAN
43151
PER/02/012013
01/01/2013
31/12/2013
7000
42
00769
PKM KADEMANGAN
-0266-322076 43292
PER/01/012013
01/01/2013
31/12/2013
7000
43
00803
PKM KADUDAMPIT
-0266-226230 43153
PER/02/012013
01/01/2013
31/12/2013
7000
44
00814
PKM KALAPANUNGGAL
-0266-620030 43151
PER/02/012013
01/01/2013
31/12/2013
7000
45
00833
PKM KALIBUNDER
43151
PER/02/012013
01/01/2013
31/12/2013
7000
46
00785
43281
PER/01/012013
01/01/2013
31/12/2013
7000
47
07048
43151
PER/03/012013
01/01/2013
31/12/2013
7000
48
00824
PKM KARAWANG
43151
PER/02/012013
01/01/2013
31/12/2013
7000
49
00775
PKM KOTA
43151
PER/01/012013
01/01/2013
31/12/2013
7000
50
00762
-0266-213830 43151
PER/03/012013
01/01/2013
31/12/2013
7000
51
00828
PKM LENGKONG
43151
PER/02/012013
01/01/2013
31/12/2013
7000
52
00770
PKM MANDE
-0266-322306 43292
PER/01/012013
01/01/2013
31/12/2013
7000
53
00790
PKM MUKA
-0266-269596 43252
PER/01/012013
01/01/2013
31/12/2013
7000
54
00801
PKM NAGRAK
-0266-532779 43151
PER/02/012013
01/01/2013
31/12/2013
7000
55
00771
PKM NAGRAK
-0266-266533 43252
PER/01/012013
01/01/2013
31/12/2013
7000
56
00764
PKM NANGGELENG
-0266-241382 43151
PER/03/012013
01/01/2013
31/12/2013
7000
57
00827
PKM NYALINDUNG
-0266-480125 43151
PER/02/012013
01/01/2013
31/12/2013
7000
58
00799
PKM PABUARAN
43151
PER/02/012013
01/01/2013
31/12/2013
7000
RI244010
PKR102001
Halaman :
Tanggal :
109/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
59
00765
PKM PABUARAN
60
00772
PKM PACET
-0266-264274 43252
61
00811
PKM PARAKANSALAK
62
00812
PKM PARUNGKUDA
63
00819
64
00807
65
43151
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
31/12/2013
7000
PER/03/012013
PER/01/012013
01/01/2013
31/12/2013
7000
43151
PER/02/012013
01/01/2013
31/12/2013
7000
43151
PER/02/012013
01/01/2013
31/12/2013
7000
43151
PER/02/012013
01/01/2013
31/12/2013
7000
PKM PURABAYA
43151
PER/02/012013
01/01/2013
31/12/2013
7000
00829
PKM SAGARATEN
-0266-341009 43151
PER/02/012013
01/01/2013
31/12/2013
7000
66
00766
PKM SELABATU
-0266-229944 43151
PER/03/012013
01/01/2013
31/12/2013
7000
67
00820
PKM SIPENAN
-0266-431964 43151
PER/02/012013
01/01/2013
31/12/2013
7000
68
00763
PKM SUKABUMI
-0266-231890 43151
PER/03/012013
01/01/2013
31/12/2013
7000
69
00806
PKM SUKALARANG
-0266-260120 43151
PER/02/012013
01/01/2013
31/12/2013
7000
70
00777
PKM SUKANAGARA
-0266-240118 43264
PER/01/012013
01/01/2013
31/12/2013
7000
71
00823
PKM SUKARAJA
-0266-230067 43151
PER/02/012013
01/01/2013
31/12/2013
7000
72
00789
PKM SUKARESMI
-0266-284104 43254
PER/01/012013
01/01/2013
31/12/2013
7000
73
00834
PKM SURADE
-0266-490123 43151
PER/02/012013
01/01/2013
31/12/2013
7000
74
00778
PKM TANGGEUNG
-0266-343457 43267
PER/01/012013
01/01/2013
31/12/2013
7000
75
00837
PKM TIPAR
-0266-222985 43151
PER/03/012013
01/01/2013
31/12/2013
7000
76
00797
PKM WALURAN
-0266-267036 43151
PER/02/012013
01/01/2013
31/12/2013
7000
77
00818
-0266-321182 43151
PER/02/012013
01/01/2013
31/12/2013
7000
78
00810
PKM WARUNGKONDANG
0263-272273
43252
PER/01/012013
01/01/2013
31/12/2013
7000
79
02756
-0266-242166 43151
PER/03/012013
01/01/2013
31/12/2013
7000
80
02759
PUSKESMAS CIKUNDUL
JL PROKLAMASI SUKABUMI
-0266-240041 43151
PER/03/012013
01/01/2013
31/12/2013
7000
81
02760
-0266-512465 43151
PER/07/012008
01/01/2008
31/12/2008
7000
82
02757
-0266-210767 43122
PER/03/012013
01/01/2013
31/12/2013
7000
83
02758
PUSKESMAS SUKAKARYA
JL TEGAL WANGI
-0266-215558 43151
PER/03/012013
01/01/2013
31/12/2013
7000
84
08098
BP CITRA INSANI
0266-221467
43132
0266-230414
DR MOCHAMMAD YUSUF
85
06108
0266-733767
43359
86
07067
43151
87
08097
KLINIK ALIYYA
0263-262063
43211
DR YANOVA
TRIMUJASMARA,M.M.KES
RI244010
7000
PER/27/102012
01/11/2012
31/12/2013
PER/07/012013
01/01/2013
31/12/2013
7000
PER/05/012013
01/01/2013
31/12/2013
7000
PER/26/102012
01/11/2012
31/12/2013
7000
PKR102001
Halaman :
Tanggal :
110/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
SABTU
PER/09/012013
01/01/2013
31/12/2013
7000
PER/14/012013
01/01/2013
31/12/2013
7000
PER/22/042012
01/04/2012
31/03/2013
7000
PER/08/012013
01/01/2013
31/12/2013
7000
PER/11/012013
01/01/2013
31/12/2013
7000
PER/04/012013
01/01/2013
31/12/2013
14000
PER/29/112012
01/11/2012
31/12/2013
500
PER/10/012013
01/01/2013
31/12/2013
7000
PER/02/012013
01/01/2013
31/12/2013
PER/21/012012
01/01/2012
31/12/2012
7000
88
06280
KLINIK ASRI
0263-268883
43282
IYUS KUSWAYA
89
04391
0266-537161
43151
DR. II MASWAKI HS SH
90
06567
0266-6324417 43157
91
07049
KLINIK GLOBAL MEDICAL CENTER KOTA SMI JL. PERINTIS KEMERDEKAAN KOMP. RUKO NO. 6, GN.
PARANG, CIKOLE ( DEPAN LAP. MERDEKA)
0266-249507
43152
92
07960
KLINIK KENMUGI
0266-244328
43151
0266-244328
93
04500
-0266-707339 43357
94
07568
JL. RAYA KARANG TENGAH NO. 721A, DS. KARANG TENGAH, -081310035810 43151
RT. 02 / 04, CIBADAK
95
07506
0266-210909
JL.PELABUHAN II NO. 463 ( PERTIGAAN JALUR LINGKAR
SELATAN SMI ) RT. 04/01 KEC. LEMBURSITU KOTA SUKABUMI
43151
0266-210909
96
00831
43151
97
04302
-0266229207
43151
98
07066
RSUD CIMACAN
0263-512465
43253
0263-512465
99
03507
-0266261026
43252
100
04140
101
00841
RSUD R SAMSUDIN SH
102
03508
103
-731256
v
v
v
v
7000
PER/19/012012
01/01/2012
31/12/2012
7000
PER/17/012012
01/01/2012
31/12/2012
7000
-0266-432081 43152
-0266-432082
PER/20/012012
01/01/2012
31/12/2012
7000
-0266-225180 43151
PER/16/012012
01/01/2012
31/12/2012
7000
RSUD SEKARWANGI
-026643351
43151
PER/18/012012
01/01/2012
31/12/2012
7000
07304
0266-731555
43359
0266-735551
SUPRIADI SETIAWAN
PER/23/052012
01/05/2012
30/04/2013
104
04905
43252
SYAFRIZAL
105
05966
0263-262882
43252
IYUS KUSWAYA
106
03898
APOTIK CIBADAK
-0266-536490 43351
107
03895
JL VETERAN II NO 2 SUKABUMI
0266-221465
108
03896
APOTIK KITA
JL SURYAKENCANA NO 58 SUKABUMI
109
07507
110
03899
111
112
70
PER/14/012012
01/01/2012
31/12/2012
PER/15/012012
01/01/2012
31/12/2012
7000
43351
PER/10/012012
01/01/2012
31/12/2012
7000
-0266-224837 43351
PER/11/012012
01/01/2012
31/12/2012
7000
JL. JEND. AHMAD YANI RT. 04/05 KEL./KEC. PELABUHAN RATU 0266-7045317 43153
0266-7045317 ABIDIN
PER/24/092011
01/09/2011
31/08/2012
APOTIK SEKARWANGI
-0266-536111 43151
PER/13/012012
01/01/2012
31/12/2012
7000
03897
APOTIK WALUYA
-0266-221370 43351
PER/12/012012
01/01/2012
31/12/2012
7000
07304
RS BHAKTI MEDICARE
0266-731555
0266-735551
PER/01/TC/052012
01/05/2012
30/04/2013
RI244010
43359
SUPRIADI SETIAWAN
9000
PKR102001
Halaman :
Tanggal :
111/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
01/06/2012
31/05/2013
7000
01/06/2012
31/05/2013
7000
01/06/2012
31/05/2013
7000
01/06/2012
31/05/2013
7000
-0265-231553 44151
01/06/2012
31/05/2013
7000
0265-321323
46151
01/06/2012
31/05/2013
7000
PKM KARANGPAWITAN
-0265-442236 44151
01/06/2012
31/05/2013
7000
00864
PKM KAWALU
0265-326006
46151
01/06/2012
31/05/2013
7000
00856
PKM LELES
0262-2458426 44151
01/06/2012
31/05/2013
7000
10
03606
44151
01/06/2012
31/05/2013
7000
11
00874
PKM PANGANDARAN
0265-639118
46396
01/06/2012
31/05/2013
12
00879
PKM PASUNDAN
-0265-231372 44151
01/06/2012
31/05/2013
7000
13
00875
PKM PATARUMAN
0265-744176
46383
01/06/2012
31/05/2013
7000
14
00857
PKM PEMBANGUNAN
-0265-231661 44151
01/06/2012
31/05/2013
7000
15
00860
PKM SAMARANG
-0265-542342 44151
01/06/2012
31/05/2013
7000
16
00851
PKM SILIWANGI
-0262-231364 44151
01/06/2012
31/05/2013
7000
17
00859
PKM TAROGONG
-0265-231511 44151
01/06/2012
31/05/2013
7000
18
00867
PKM TAWANG
0265-331840
46151
01/06/2012
31/05/2013
7000
19
02681
0265-772109
46252
01/06/2012
31/05/2013
7000
20
02684
PUSKESMAS CIHIDEUNG
0265-326340
46151
01/06/2012
31/05/2013
7000
21
02688
PUSKESMAS MANDALIKA
0265-773257
46252
01/06/2012
31/05/2013
7000
22
07762
0262-432155
44151
0262-432155
01/03/2012
28/02/2013
1000
23
062380
44151
0817-9119839
PER/33/072012
01/07/2012
31/05/2013
1000
24
07872
0852-94250292 46252
PER/20/052012
01/05/2012
30/04/2013
700
00870
PKM BOYONGBONG
-0265-234070 44151
00865
PKM CILEMBANG
0265-322066
46151
00866
PKM CIPEDES
0265-331176
46151
00880
PKM GUNTUR
-0265-232265 44151
00858
PKM HAURPANGGUNG
00873
PKM KAHURIPAN
00852
RI244010
YAYASAN AL YAMIN
HENI NURHAENI
7000
PKR102001
Halaman :
Tanggal :
112/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/02/012013
01/01/2013
31/12/2013
7000
PER/37/082012
01/08/2012
31/10/2013
1000
PER/04/012012
01/02/2012
31/01/2013
10000
DR BETA SELINIA
PER/13/022012
01/03/2012
28/02/2013
7000
PER/17/032012
01/04/2012
31/03/2013
PER/15/032012
01/04/2012
31/03/2013
PER/34/072012
01/07/2012
31/05/2013
DR H HADI HARSONO
PER/21/052012
01/05/2012
30/04/2013
7000
DR MUZWAR ANWAR
PER/14/022012
01/03/2012
28/02/2013
7000
46154
DR H TATA T RACHMAN
PER/22/052012
01/05/2012
30/04/2013
7000
46152
DR HASNI MUKTI
PER/46/102012
01/11/2012
31/12/2013
7000
0813-23197291 46153
DR JUSTANTO ES
PER/12/022012
01/03/2012
28/02/2013
7000
DR. E. RAHMAT
-08122069002 44151
DR. E. RAHMAT
PER/44/092012
01/10/2012
31/12/2013
05094
0265-566367
46111
PER/40/082012
01/09/2012
31/10/2013
1000
39
06063
-081802025050 46153
PER/01/012013
01/01/2013
31/12/2013
2000
40
06723
0262-2520041 44164
DR SUNARTO
PER/32/072012
01/07/2012
31/05/2013
500
41
07544
KLINIK BAITURRAHMAN
44151
PER/45/092012
01/10/2012
31/12/2013
2000
42
05069
KLINIK CISANCA
0262-541993
44161
PER/38/082012
01/09/2012
31/10/2013
2500
43
05072
KLINIK MELATI
46122
SYARIF HIDAYATULLAH
PER/39/082012
01/09/2012
31/10/2013
10000
44
04606
JL KABUPATEN NO 17 GARUT
-081325673196 44162
PER/28/062012
01/07/2012
31/05/2013
7000
45
04851
KLINIK NABILA
0265-455112
46156
DR MUHAMAD ROMIDON
PER/41/072012
01/07/2012
31/10/2012
46
04852
KLINIK NURHAYATI
44151
PER/03/012012
01/02/2012
31/01/2013
47
07870
0265-546129
46111
PER/19/042012
01/05/2012
30/04/2013
48
03449
POLIKLINIK AL AMANAH
0262-540472
44151
DR HIBBAN MUTTAQIN
PER/18/042012
01/05/2012
30/04/2013
25
04633
-081323048757 44151
TATI JULIAH
26
07462
BP PADJAJARAN KARANGPAWITAN
0852-20111124 44151
RS PADJAJARAN
27
04853
46381
28
03868
DR BETA SELINIA
-081320209379 46151
29
04404
DR EDDI SADARYUN
-081323557026 46151
30
04933
DR FAISAL SOEPARIANTO
0265-7087752 46111
31
03908
DR H WAHYA
-08122172180 46151
32
05527
DR H HADI HARSONO
08592-7750252 44151
33
05070
DR H MUZWAR ANWAR
-08122127697 46151
34
04385
DR H TATA T RACHMAN
35
03450
DR HASNI MUKTI
0265-338954
36
04197
DR JUSTANTO ES
37
05157
38
RI244010
DR FAISAL SOPARIANTO
10000
v
v
7000
2000
800
10000
v
v
v
7000
1000
7000
Halaman :
Tanggal :
113/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
49
02686
RESTITUSI TASIKMALAYA
TASIKMALAYA
46111
50
07532
0262-235751
44151
0262-232325
51
00843
RSU CIAMIS
0265-771018
46252
52
04201
0265-741032
46381
0265-744730
53
00842
RSU TASIKMALAYA
-0265-331683 46151
54
0000
RSU. CIAMIS
55
00845
RSU. GARUT
56
05093
57
HARI BUKA
PPK II
APT
NO IKS
KAMIS, JUM'AT,
SABTU, MINGG
POLA PEMBIAYAAN
JAM BUKA
JUMLAH
TTG
01/10/2012
31/12/2013
7000
PER/03/012013
01/01/2013
31/12/2013
10000
PER/48/062012
01/06/2012
31/12/2013
7000
PER/04/012013
01/01/2013
31/12/2013
7000
46252
IKS/10/072005
01/01/2006
31/12/2007
7000
-0265-237767 44151
PER/06/012013
01/01/2013
31/12/2013
7000
0265-323868
46111
0265-327630
PER/16/032012
01/01/2012
31/12/2012
10000
07338
JL IR H JUANDA NO. 1
0265-332555
46111
0265-342496
PER/29/062012
01/06/2012
31/05/2013
58
05068
0265-331224
46151
PER/31/072012
01/07/2012
31/05/2013
59
00848
-0265-232720 44151
PER/14/032011
01/12/2010
31/12/2012
7000
60
00849
-0265-331683 46111
IKS/09/052005
02/05/2005
01/05/2007
7000
61
08000
JL RSUD BANJAR NO 5
0265-741032
46381
PER/35/072012
01/08/2012
31/10/2013
62
03608
APOTEK SAGA
-0262-234595 44151
PER/08/022012
01/02/2012
31/01/2013
63
03453
APOTIK GARUT
0262-233040
44151
PER/30/062012
01/06/2012
31/05/2013
64
04932
MIAN OPTIKAL
JL PASUNDAN NO 15
44151
H MIAN SUHERMAN
PER/50/112012
01/04/2012
31/12/2013
65
03808
OPTIK LATANSA
-081322052627 46151
H. ANANG ISKANDAR
PER/47/112012
01/11/2012
31/12/2013
7000
66
06511
OPTIK MODERN
0265-313638
46111
RINALDI YUSRIL
PER/09/022012
01/02/2012
31/01/2013
7000
67
00850
TAUFIK OPTICAL
0265-233583
44151
GAGAN
PER/51/112012
01/02/2012
31/12/2013
7000
RI244010
7000
7000
PKR102001
Halaman :
Tanggal :
114/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/329/082012
01/09/2012
31/12/2013
14000
PER/22/122012
01/01/2013
31/12/2013
7000
PER/10/122012
01/01/2013
31/12/2013
7000
PER/11/122012
01/01/2013
31/12/2013
7000
PER/12/122012
01/01/2013
31/12/2013
7000
-0260-713290 41272
PER/13/122012
01/01/2013
31/12/2013
7000
-0260-451027 41252
PER/14/122012
01/01/2013
31/12/2013
7000
-0260-416815 41271
PER/15/122012
01/01/2013
31/12/2013
7000
03760
PUSKESMAS JL CAGAK
0260-470118
41271
PER/331/082012
01/09/2012
31/12/2013
7000
10
05327
PUSKESMAS PABUARAN
0260-711722
41272
PER/26/122012
01/01/2013
31/12/2013
7000
11
03761
PUSKESMAS PLERED
-0264271767
41171
PER/327/082012
01/08/2012
31/12/2013
7000
12
03513
PUSKESMAS SUKARAHAYU
41281
PER/16/122012
01/01/2013
31/12/2013
7000
13
03512
PUSKESMAS SUKATANI
JL RAYA SUKATANI
-0264-272408 41151
PER/17/122012
01/01/2013
31/12/2013
7000
14
03819
-022-6970561 40376
PER/332/082012
01/09/2012
31/12/2013
15
07130
BP INSAN MADANI
41252
PER/27/122012
01/01/2013
31/12/2013
7000
16
01005
-0264-201722 41181
PER/18/122012
01/01/2013
31/12/2013
14000
17
05933
41252
DR PEPEN SE
PER/338/082012
01/09/2012
31/12/2013
7000
18
00974
-0260-551212 41253
PER/19/122012
01/01/2013
31/12/2013
7000
19
05679
41151
DR PEPEN
PER/325/082012
01/08/2012
31/12/2013
14000
20
04889
41171
NURUL
PER/23/122012
01/01/2013
31/12/2013
14000
21
03795
-0264-620328 41151
HJ IPAH
PER/348/112012
01/12/2012
31/12/2013
14000
22
05619
0264-205002
16411
DR H HAERUDIN
PER/06/122012
01/01/2013
31/12/2013
14000
23
03514
KLINIK CAMPAKA
-0811980213
41151
DR. NATALIA
PER/07/122012
01/01/2013
31/12/2013
14000
24
07904
0260-7714189 41255
DR. MULYADI
PER/42/012013
01/01/2013
31/12/2013
03818
KLINIK ANGKASA
-0260-460335 41271
05154
PKM CIASEM
0260-521666
41253
00984
PKM CIBATU
-0264-204959 41181
00993
PKM CIBOGO
JL CIBOGO SUBANG
-0260-515964 41285
00983
PKM CIKALAPA
-0260-420887 41261
00980
PKM CIPEUNDEUY
00994
PKM PAGADEN
00995
RI244010
ASEP SETIAWAN.,SE
HJ. YEYET S
3500
200
PKR102001
Halaman :
Tanggal :
115/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/08/122012
01/01/2013
31/12/2013
7000
PER/24/122012
01/01/2013
31/12/2013
14000
PER/342/102012
01/11/2012
31/12/2013
PER/25/122012
01/01/2013
31/12/2013
14000
PER/326/082012
01/08/2012
31/12/2013
7000
PER/04/122012
01/01/2013
31/12/2013
25
06741
KLINIK DR CHAERUDDIN
41286
DR CHAERUDDIN
26
06080
KLINIK KALIJATI
41257
ARIF SETYANTOKO
27
06370
KLINIK KORPRI
JL. OTISTA
0260-
41252
28
05386
-0811980213
41171
DR NATALIA INDAWATY
29
06742
41151
PT. NAYAKA
30
07332
KLINIK PAHLAWAN
0264-216529
41151
31
03823
32
06081
KLINIK RADIATIE
33
07687
KLINIK TAZAKKA
0264-7020877 41152
34
00976
KLINIK WALUYA
JL RE MARTADINATA NO 58 PWKT
35
03762
RB PUJA ANANDA
36
05853
37
7000
200
PER/330/082012
01/09/2012
31/12/2013
14000
DR PEPEN SE
PER/20/122012
01/01/2013
31/12/2013
14000
0264-209877
PER/21/122012
01/01/2013
31/12/2013
7000
-0264-200934 41151
DR PEPEN SE
PER/09/122012
01/01/2013
31/12/2013
14000
-08172342978 41171
SUSILAWATI
PER/350/122012
01/12/2012
31/12/2013
7000
RB SAYANG BUNDA
0264-200797
41151
DRS H M SUKIRMAN MM
PER/333/082012
01/09/2012
31/12/2013
7000
05932
41164
PER/349/112012
01/12/2012
31/12/2013
7000
38
03518
JL KATAMSO NO 37
-0260-411421 41271
PER/29/122012
01/01/2013
31/12/2013
7000
39
03517
JL VETERAN NO 39
-0264-200100 41172
PER/30/122012
01/01/2013
31/12/2013
7000
40
05062
0264-200011
41151
PER/351/122012
01/12/2012
31/12/2013
7000
41
07346
RS EFARINA ETAHAM
JL BUNGURSARI NO. 1
0364-219168
41152
PER/05/122012
01/01/2013
31/01/2013
42
06347
0264-202136
41151
PER/335/082012
01/09/2012
31/12/2013
43
06083
RS MH THAMRIN INTERNASIONAL
PURWAKARTA
0264-8222222 41152
PER/28/122012
01/01/2013
31/12/2013
44
07777
JL VETERAN SADANG NO 15
0264-211680
0264-219407
PER/31/122012
01/01/2013
31/12/2013
45
06079
0813-21197539 16411
PER/32/122012
01/01/2013
31/12/2013
46
03516
APOTIK PERDANA
JL VETERAN NO 38
-0264-214914 41171
SOESANTO
PER/03/122012
01/01/2013
31/12/2013
47
05139
APOTIK PRIMA
0264-8224545 41151
ADITYO AKBAR
PER/341/102012
01/10/2012
31/12/2013
48
00999
0264-202382
41171
PER/334/082012
01/09/2012
31/12/2013
49
07580
OPTIK BUANA
0264-207595
41151
TOMTOM BUSTOMI
PER/02/122012
01/01/2013
31/12/2013
50
01003
OPTIK EVA
41171
SUGIONO BINSY, RO
PER/352/122012
01/12/2012
31/12/2013
41152
41151
H.RUSTANDIE,SH
7000
7000
RI244010
PKR102001
Halaman :
Tanggal :
116/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
51
05561
52
RI244010
YOGI OPTIKAL
-081322848886 41252
JL BUNGURSARI NO. 1
0264-219168
41151
H.DADANG SUDRAJAT,RO
-
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/01/122012
01/01/2013
31/12/2013
PER/294/032012
28/03/2012
28/03/2013
PKR102001
Halaman :
Tanggal :
117/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/13/042012
01/05/2012
30/04/2013
7000
PER/13/042012
01/05/2012
30/04/2013
7000
PER/13/042012
01/05/2012
30/04/2013
7000
PER/13/042012
01/05/2012
30/04/2013
7000
41352
PER/13/042012
01/05/2012
30/04/2013
7000
41373
PER/13/042012
01/05/2012
30/04/2013
7000
PER/13/042012
01/05/2012
30/04/2013
7000
41352
PER/13/042012
01/05/2012
30/04/2013
7000
0267-402276
41352
PER/13/042012
01/05/2012
30/04/2013
7000
0267-402276
41352
PER/13/042012
01/05/2012
30/04/2013
7000
PKM KLARI
0267-402276
41352
PER/13/042012
01/05/2012
30/04/2013
7000
01034
PKM MAJALAYA
DS MAJALAYA KARAWANG
0267-402276
41352
PER/13/042012
01/05/2012
30/04/2013
7000
13
01035
PKM NAGASARI
0267-402276
41352
PER/13/042012
01/05/2012
30/04/2013
7000
14
02769
PKM PALAWAD
0267-402276
41352
PER/13/042012
01/05/2012
30/04/2013
7000
15
01012
PKM PANGKALAN
0267-402276
PER/13/042012
01/05/2012
30/04/2013
7000
16
01008
PKM PURWASARI
0267-402276
PER/13/042012
01/05/2012
30/04/2013
7000
17
02764
PKM RAWAMERTA
KARAWANG
0267-402276
PER/13/042012
01/05/2012
30/04/2013
7000
18
01007
PKM RENGASDENGKLOK
0267-402276
PER/13/042012
01/05/2012
30/04/2013
7000
19
01016
-0267-402276 41352
PER/16/042012
01/05/2012
30/04/2013
7000
20
01038
0267-402276
41352
PER/13/042012
01/05/2012
30/04/2013
7000
21
02765
PKM TIRTAMULYA
TIRTAMULYA KARAWANG
0267-402276
41352
PER/13/042012
01/05/2012
30/04/2013
7000
22
01017
0267-402276
41352
PER/13/042012
01/05/2012
30/04/2013
7000
23
01015
PKM WADAS
0267-402276
41352
PER/13/042012
01/05/2012
30/04/2013
7000
24
01009
PKM WANAKERTA
0267-402276
PER/13/042012
01/05/2012
30/04/2013
7000
01037
PKM ADIARSA
0267-40227
41352
01040
PKM ANGGADITA
0267-402276
41352
02768
0267-402276
41352
01011
PKM CIAMPEL
- 0267-40227
41352
01036
PKM CIKAMPEK
0267-402276
01013
0267-402276
01010
PKM CILAMAYA
0267-402276
02763
JATISARI KARAWANG
0267-402276
01014
PKM JOMIN
10
01006
PKM KARAWANG
11
01039
12
RI244010
41352
PKR102001
Halaman :
Tanggal :
118/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/55/112012
01/11/2012
31/10/2013
14000
PER/32/112012
01/11/2012
31/10/2013
7000
PER/31/112012
01/11/2012
31/10/2013
14000
PER/45/112012
01/11/2012
31/10/2013
14000
DR. H. AKHID
PER/33/112012
01/11/2012
31/10/2013
10000
-0267-482585 41352
DR.ENDANG MA'MUR,MM.MBA
-0264-435013 41352
0267-641968
41352
01024
0267-641879
41352
35
01029
0264-310101
36
02773
37
07018
KLINIK JATISARI
38
01031
39
25
01027
0267-8453903 41352
26
01025
0267-433091
27
02772
28
04324
29
06264
30
0267-8453903 H. SUDIARTO
41352
H. ENDANG SUHERLAN
0267-435527
41352
0264-310101
0267-433636
41352
0267-8615577
41361
02767
-0267-511321 41352
31
01026
32
01020
33
01018
34
7000
PER/53/112012
01/11/2012
31/10/2013
PER/49/112012
01/11/2012
31/10/2013
7000
PER/28/112012
01/11/2012
31/10/2013
7000
TRI WAHYUDADI
PER/35/112012
01/11/2012
31/10/2013
10000
H. ENDANG SUHERLAN
PER/42/112012
01/11/2012
31/10/2013
7000
41352
PER/38/112012
01/11/2012
31/10/2013
14000
0264-340202
41352
PER/27/112012
01/11/2012
31/10/2013
10000
JL JATISARI
0264-360434
41372
PER/54/112012
01/11/2012
31/10/2013
10000
KLINIK LAMARAN
0267-8453951 41352
EDDY SUWANDHI
PER/44/112012
01/11/2012
31/10/2013
10000
07755
0267-8616923 41352
DR YUSAK BENYAMIN
PER/56/112012
01/11/2012
31/10/2013
5000
40
01019
0267-433930
41352
PER/37/112012
01/11/2012
31/10/2013
7000
41
06263
0267-643895
41361
0267-643895
PER/34/112012
01/11/2012
31/10/2013
7000
42
02771
0264-303558
41352
DR. AKHID
PER/39/112012
01/11/2012
31/10/2013
14000
43
05831
41352
DR AKHID
PER/36/112012
01/11/2012
31/10/2013
7000
44
01023
0267-433653
41352
H. SUDIARTO
PER/30/112012
01/11/2012
31/10/2013
10000
45
06997
0264-312977
41372
LUTFI
PER/43/112012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT
3,SHIFT 6,SHIFT 7,SHIFT
KAMIS, JUM'AT,
2,SHIFT 4,SHIFT 508.0), GIGI
SABTU, MINGG
(SHIFT 1)
01/11/2012
31/10/2013
14000
46
07754
-085715208194 41352
YAYAT SALEH
PER/50/112012
01/11/2012
31/10/2013
5000
47
08087
0267-8453276 41352
0267-408954
DR.HERYANTO
PER/26/112012
01/11/2012
31/10/2013
10000
48
06996
KLINIK SYAFIRA
41372
62085288393912
PER/41/112012
01/11/2012
31/10/2013
14000
RI244010
PKR102001
Halaman :
Tanggal :
119/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
SABTU, MINGG
49
01022
KLINIK TELAGASARI
0267-510771
41352
DR.HJ.IDA LISNURIDA
PER/48/112012
01/11/2012
31/10/2013
10000
50
01032
KLINIK YAKESTI
0267-432416
41361
021-8253516
PER/29/112012
01/11/2012
31/10/2013
10000
51
01021
KLINIK YASMIN
0264-312009
41352
PER/46/112011
01/11/2012
31/10/2013
10000
52
07756
MITRA GEMPOL
0267-483749
41352
PER/40/112012
01/11/2012
31/10/2013
5000
53
07277
RB.SAYANG BUNDA
0264-9144784 41361
0264-360434
DR.H.ASEP L, MM
PER/16/04/2012
01/05/2012
30/04/2013
5000
54
07509
RB.SITI AZARIA
0267-8615368 41352
55
07906
0267-315625
56
06824
0267-8616801 41371
57
07005
58
01033
PKM CURUG
59
01041
60
PER/20/092012
01/09/2012
31/08/2013
5000
PER/018/052012
01/06/2012
31/05/2013
5000
PER/21/092012
01/09/2012
31/08/2013
14000
62-0811892567 41383
PER/06/012013
01/01/2013
31/12/2013
7000
0267-402276
PER/13/042012
01/05/2012
30/04/2013
RSUD KARAWANG
0267-640555
41352
0267-640666
PER/057/012012
01/01/2012
31/12/2012
08056
RS KARYA HUSADA
0264-316189
41352
0264-312834
HJ NURKARYATI
PER/23/102012
01/10/2012
30/09/2013
61
04687
0267-414520
41352
0267-413277
YAYASAN SINGAPERBANGSA
PER/059/012012
01/01/2012
31/12/2012
62
06378
0267-437507
41382
0267-438681
PER/058/112012
01/11/2012
31/10/2013
63
06590
RSU. AQMA
0264-8386830 41385
PER/22/102012
01/10/2012
30/09/2013
64
01045
0267-8458601 41352
PER/02/012013
01/01/2013
31/12/2013
65
07859
0267-8453905 41361
PER/10/042012
01/05/2012
30/04/2013
66
06125
APOTEK SERASI 2
0267-403779
PER/09/042012
01/04/2012
31/03/2013
67
06998
APOTIK ANUGRAH
6241372
085211115067
0267-400966
AI MURFIAH
PER/060/012012
01/01/2012
31/12/2012
68
03611
APOTIK KURNIA
-0267-405614 41352
PER/03/012013
01/01/2013
31/12/2013
69
04688
0267-414520
41352
0267-413277
YAYASAN SINGAPERBANGSA
PER/058/012012
01/01/2012
31/12/2012
70
06379
0267-437507
41382
0267-438681
PER/057/112012
01/12/2012
31/10/2013
71
06591
0264-8386830 41385
PER/57/112012
01/10/2012
30/09/2013
72
04065
OPTIK ASIA
0267-402563
41352
PER/51/112012
01/11/2012
31/10/2013
73
04417
OPTIK CITRA
0267-405172
41352
WISMA NATHAN
PER/52/112012
01/11/2012
31/10/2013
74
41352
PER/19/042012
01/04/2012
31/03/2013
RI244010
41352
41361
H.ENDANG NANDANG
DR SAEPUDIN MPH
v
v
7000
7000
7000
7000
PKR102001
Halaman :
Tanggal :
120/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
31/12/2013
7000
PER/102/112012
01/12/2012
31/12/2013
7000
PER/110/112012
01/12/2012
31/12/2013
7000
PER/113/112012
01/12/2012
31/12/2013
7000
PER/92/112012
01/12/2012
31/12/2013
7000
PER/95/112012
01/12/2012
31/12/2013
7000
PER/103/112012
01/12/2012
31/12/2013
7000
PER/93/112012
01/12/2012
31/12/2013
14000
PER/94/112012
01/12/2012
31/12/2013
7000
PER/107/112012
01/12/2012
31/12/2013
14000
DR HUTAMA YONATHAN
PER/91/112012
01/12/2012
31/12/2013
7000
PER/88/112012
01/12/2012
31/12/2013
14000
PER/104/112012
01/12/2012
31/12/2013
7000
PER/108/112012
01/12/2012
31/12/2013
7000
PER/89/112012
01/12/2012
31/12/2013
7000
ENDANG HARTATI
PER/99/112012
01/12/2012
31/12/2013
7000
PER/96/112012
01/12/2012
31/12/2013
7000
-022-6674156 40262
DR HADI HARIONO
PER/90/112012
01/12/2012
31/12/2013
7000
-022-6647754 40262
PER/87/112012
01/12/2012
31/12/2013
7000
DR HENRY JRT
-08122348167 40376
PER/97/112012
01/12/2012
31/12/2013
7000
01057
DR AGUSTINA INDRAWATI A
32304
DR AGUSTINA INDRAWATI A
PER/86/112012
01/12/2012
28/02/2013
7000
22
07749
-0816600247
40252
PER/114/112012
01/12/2012
31/12/2013
7000
23
04561
DRG S HARYOSENO
-NULL
40262
DRG S HARYOSENO
PER/105/112012
01/12/2012
31/12/2013
14000
24
01127
KLINIK AL-ABINA
-022-6676527 40553
DR A AZIZ ASOPARIE
PER/100/112012
01/12/2012
28/02/2013
7000
01125
BP BATUJAJAR
-022-6866507 40376
01163
-0260-470551 41252
05968
JL RADIO NO 1 CILILIN
022-6940069
022-6940069
06402
PUSKESMAS GUNUNGHALU
JL RAYA GUNUNGHALU NO 49
-081320261234 40554
01098
BP BUDI LUHUR
-022-6674146 40553
DR PANDITH ARISMUNANDAR
01104
BP AL IKHLAS I
022-6808181
40553
H ADNAN IBRAHIM
03679
BP AL IKHLAS III
-81320793875 40262
ADNAN IBRAHIM
01100
BP ASRYFA II
-08122105480 40262
LATIFAH
01101
BP ASRYFA III
-08122105480
10
04776
BP LUHUR MEDICA
022-6650638
40376
11
01078
BP MITRA MEDIKA
-08122308750 40262
12
01062
-08156211403 40553
13
03920
-022-6075387 40262
DR EVI DEWI
14
05687
022-6626988
40525
15
01075
BP PANORAMA
-022-6626988 40553
DR SUKMAHADI TAWAF
16
01126
BP RAHARDJA
-08122240422 40552
17
01107
BP SEHAT BAHAGIA
022-76262868 40553
18
01079
BP SILIWANGI SEHAT
19
01061
BP SINDANG SARI
20
01123
21
RI244010
40562
v
v
PKR102001
Halaman :
Tanggal :
121/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/111/112012
01/12/2012
31/12/2013
7000
PER/112/112012
01/12/2012
31/12/2013
7000
PER/109/112012
01/12/2012
31/12/2013
7000
PER/101/112012
01/12/2012
31/12/2013
7000
PER/106/112012
01/12/2012
31/12/2013
14000
PER/59/062012
01/07/2012
31/12/2012
7000
PER/55/062012
01/07/2012
30/06/2013
7000
PER/10/042011
01/04/2011
30/06/2011
7000
PER/57/062012
01/07/2012
30/06/2013
7000
25
06400
KLINIK CIAMPEL
-081322177183 40553
DR ARIEF BUDIANA
26
06401
KLINIK IZZATI
022-6646978
40551
27
05967
40561
28
01129
-08156171258 40561
DR YONDRI ARSYAD
29
04569
-NULL
40553
30
01131
RS DUSTIRA
-022-6652156 40562
31
01134
RSU CIBABAT
-022-6652025 40142
32
03875
RS MITRA KASIH
-022-6654852
33
04647
40252
34
05394
JL CIHANJUANG NO 8 CIMAHI
022-6650638
40561
022-6646626
35
01242
APOTIK PRIMAD
-022-6647147 40396
36
04778
OPTIK ARIMBI
JL GUNUNG BATU NO 93
022-6641149
40172
HENDRAYANI,SE.
37
01141
OPTIK RAYA
40252
38
04648
OPTIK RAYA
022-6334911
40561
39
05396
40
05395
41
1100000000027 RS DUSTIRA
RI244010
HARI BUKA
PPK II
v
v
v
v
v
v
PER/51/062012
01/07/2012
30/06/2013
7000
PER/58/062012
01/07/2012
30/06/2013
7000
PER/56/062012
01/07/2012
30/06/2013
7000
CHEPY AHMAD
PER/54/062012
01/07/2012
30/06/2013
7000
PER/50/062012
01/07/2012
30/06/2013
7000
022-70712259 40562
RETNO WULANDARI
PER/53/062012
01/07/2012
30/06/2013
7000
JL CIHANJUANG NO 8 CIMAHI
022-6650638
40561
022-6646626
MOHAMMAD FAUZI
PER/52/062012
01/07/2012
30/06/2013
7000
022-6633967
40552
PER/48/062012
01/07/2012
30/06/2013
MOHAMMAD FAUZI
14000
PKR102001
Halaman :
Tanggal :
122/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
01177
BKKM
022-7798778
40376
022-7798778
01276
PKM CIMALAKA
-022-202623
45353
03438
PKM JATINANGOR
08003
BP AMODIA
05477
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/33/122012
01/01/2013
31/12/2013
15000
PER/40/122012
01/01/2013
31/12/2013
7000
-022-7796143 45363
PER/41/122012
01/01/2013
31/12/2013
7000
022-7791769
022-7797169
PER/56/122012
01/01/2013
31/12/2013
BP ARAFAH
022-76012025 40376
DR SITI SIR'ATUN
PER/48/122012
01/01/2013
31/12/2013
7000
01190
BP MEDIKA PRATAMA II
-02270822993
PER/35/122012
01/01/2013
31/12/2013
7100
04593
PT MEDIKA PRATAMA
PER/45/122012
01/01/2013
31/12/2013
7000
05171
BP. ELTIGIP
022-70557328 45353
YAYASAN PERDITA
PER/47/122012
01/01/2013
31/12/2013
5000
01187
-02291139522 45353
DR ANNA PERTIWI
PER/34/122012
01/01/2013
31/12/2013
7000
10
01216
-022-5207983
PER/038/122012
01/01/2013
31/12/2013
7000
11
01222
DR DEDE HIDAYAT
-022-5953338 40382
DR DEDE HIDAYAT
PER/39/122012
01/01/2013
31/12/2013
7000
12
01199
DR EVI RUFAIDA
DR EVI RUFAIDA
PER/36/122012
01/01/2013
31/12/2013
7000
13
06535
022-5947447
40376
PER/51/122012
01/01/2013
31/12/2013
13600
14
03442
DR H T NANANG SUMARTHA
-022-5211817 40376
DR HT NANANG SUMARTHA
PER/42/122012
01/01/2013
31/12/2013
7000
15
01210
DR HJ SRI SUGIHARTI
-022-5404914
PER/37/122012
01/01/2013
31/12/2013
7500
16
03861
-08122343246 40971
PER/043/122012
01/01/2013
31/12/2013
7500
17
04147
DR Y ISMAYANTI
0261-201745
45353
DR Y ISMAYANTI
PER/44/122012
01/01/2013
31/12/2013
7000
18
06569
-08122084604 40377
PER/52/122012
01/01/2013
31/12/2013
7000
19
08128
-085220136018 40191
01/01/2013
31/12/2013
70000
20
08129
DRG OKTAVIA
-08122015949 40191
DRG OKTAVIA
01/01/2013
31/12/2013
7000
21
04646
-081322928091 4000
DRG ROSSI R
PER/46/122012
01/01/2013
31/12/2013
15000
22
06425
022-93355552 40376
022-5203368
PER/050/122012
01/01/2013
31/12/2013
7000
23
05979
022-91192060 40395
022-5203368
PER/49/122012
01/01/2013
31/12/2013
7000
24
07911
022-85963355 40381
PT HOSPITECH SAHR
PER/55/122012
01/01/2013
31/12/2013
RI244010
40394
7000
7000
PKR102001
Halaman :
Tanggal :
123/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
25
06991
022-72215255 40382
26
08065
-0811203917
40193
27
08127
KLINIK PADJADJARAN
022-7781900
28
07638
29
07668
RS BHAYANGKARA BANDUNG
30
04123
31
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
-08122388698 WARIDJO
PER/57/122012
01/01/2013
31/12/2013
7000
40191
PT. RS PADJADJARAN
01/01/2013
31/12/2013
7000
022-5950916
40381
DR KOSIM
PER/54/122012
01/01/2013
31/12/2013
022-5229544
40252
022-5229545
022-5229544
40115
022-5229545
01235
RSUD MAJALAYA
JL CIPAKU NO 87 MAJALAYA
-022-5950395 40376
32
01234
RSUD SUMEDANG
JL PALASARI NO 80 SUMEDANG
0261-201021
45353
33
06923
RS AMC
022-7781630
40393
022-7781629
34
05695
APOTEK PALASARI
0261-202009
45353
DRS H OO ROHAENDINURHARA
35
03443
022-5953405
40376
022-5953405
RUSLI KURNIA
36
06989
BANDUNG OPTIKAL
0261-202421
45353
ISWARA MINTAPRADJA
37
022-7781630
40393
022-7781629
RI244010
BHAYANGKARA POLRI
PER/53/12012
01/01/2013
31/12/2013
7000
7000
PER/61/122012
01/01/2013
31/12/2013
PER/04/022011
01/02/2011
30/04/2011
PER/62/122012
01/01/2013
31/12/2013
7000
PER/63/122012
01/01/2013
31/12/2013
7000
PER/64/122012
01/01/2013
31/12/2013
PER/065/122012
01/01/2013
31/12/2013
PER/66/122012
01/01/2013
31/12/2013
PER/67/122012
01/01/2013
31/12/2013
PER/77/122012
01/01/2013
31/12/2013
PKR102001
Halaman :
Tanggal :
124/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
02482
07932
021-59450203 15610
06619
BP BINA SEHAT
03554
05554
BP MULYA RAHAYU
05553
15610
021-5950380
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/06/122012
01/01/2013
31/12/2013
7000
PER/30/122012
01/01/2013
31/12/2013
14000
MAHMUD JUMHUR. DR
PER/07/122012
01/01/2013
31/12/2013
7000
021-33834021
PER/08/122012
01/01/2013
31/12/2013
14000
021-99727323 15610
PER/09/122012
01/01/2013
31/12/2013
14000
BP NAUFAL DIANA
021-98038042 15710
PER/10/122012
01/01/2013
31/12/2013
14000
04386
BP OMEGA
021-59400203 15710
PER/11/122012
01/01/2013
31/12/2013
14105
05556
BP PERMATA HATI
021-59401437 15710
PER/12/122012
01/01/2013
31/12/2013
14000
05163
021-5320255
15710
KUNADI SETIONO, SE
PER/13/122012
01/01/2013
31/12/2013
14000
10
06343
021-5962690
15710
PER/14/122012
01/01/2013
31/12/2013
14000
11
03284
021-59410487
PER/15/122012
01/01/2013
31/12/2013
7000
12
07113
-08128070958 15710
PER/16/122012
01/01/2013
31/12/2013
14000
13
04387
KLINIK DR DODO
-081314129667
PER/17/122012
01/01/2013
31/12/2013
7000
14
03282
KLINIK DR SURONO
021-59492270 15810
PER/18/122012
01/01/2013
31/12/2013
7000
15
07114
021-5953241
021-5954473
R. ARDIANSYAH NUR
PER/19/122012
01/01/2013
31/12/2013
14000
16
06261
DR LOANITA M. KES
PER/20/122012
01/01/2013
31/12/2013
7000
17
07525
021-29006869 15710
PER/21/122012
01/01/2013
31/12/2013
7000
18
02481
-021-5980155
PER/22/122012
01/01/2013
31/12/2013
7000
19
02484
021-5969380
DR. ENDANG W
PER/23/122012
01/01/2013
31/12/2013
7000
20
03283
021-59401664 15211
PER/24/122012
01/01/2013
31/12/2013
14000
21
02466
-021-5952921
KUNADI SETIONO, SE
PER/25/122012
01/01/2013
31/12/2013
14000
22
06917
021-5960467
15211
DR NORA W
PER/26/122012
01/01/2013
31/12/2013
14000
23
07681
021-5950524
15710
021-5950528
DR SAMMY SANTOSO
PER/29/122012
01/01/2013
31/12/2013
14000
24
04610
-59454405
PER/27/122012
01/01/2013
31/12/2013
14000
RI244010
15820
15710
15710
PKR102001
Halaman :
Tanggal :
125/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
25
02483
021-32110413 15710
H SYUHADA NS
26
05555
RB MULYA RAHAYU
021-99727323 15610
27
05557
RB PERMATA HATI
021-59401437 15610
28
05164
RB SUAKA INSAN
021-5320255
15710
29
06417
RS MULIA INSANI
021-5962790
15710
30
05688
RS PARAMITA
15710
KAWASAN INDUSTRI CCM JL RAYA SERANG KM.28.5 KAV F 1- 0215954858/595335
8 BALARAJA
3
31
08030
32
021-5962790
RI244010
HARI BUKA
PPK II
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
PER/28/122012
01/01/2013
31/12/2013
PER/31/122012
01/01/2013
31/12/2013
PER/32/122012
01/01/2013
31/12/2013
KUNADI SETIONO, SE
PER/33/122012
01/01/2013
31/12/2013
021-5963099
PER/34/122012
01/01/2013
31/12/2013
DR SUMARSUDI SP.B
PER/35/122012
01/01/2013
31/12/2013
021-59491011 15810
021-5982788
PER/36/122012
01/01/2013
31/12/2013
15710
021-5963099
PER/37/122012
01/01/2013
31/12/2013
JUMLAH
TTG
PKR102001
Halaman :
Tanggal :
126/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/28/052012
01/05/2012
30/04/2013
7000
PER/28/052012
01/05/2012
30/04/2013
7000
PER/28/052012
01/05/2012
30/04/2013
7000
PER/28/052012
01/05/2012
30/04/2013
7000
PER/28/052012
01/05/2012
30/04/2013
7000
PER/28/052012
01/05/2012
30/04/2013
7000
17510
PER/28/052012
01/05/2012
30/04/2013
7000
17530
PER/28/052012
01/05/2012
30/04/2013
7000
JL. RAYA BABAKAN KONGSI RT 04/02 DS. SUMBER URIP KEC. PEBAYURAN
17710
PER/28/052012
01/05/2012
30/04/2013
7000
02816
17356
PER/28/052012
01/05/2012
30/04/2013
7000
11
02809
17540
PER/28/052012
01/05/2012
30/04/2013
7000
12
00506
17540
PER/28/052012
01/05/2012
30/04/2013
7000
13
00505
-89140112
17530
PER/28/052012
01/05/2012
30/04/2013
7000
14
00524
17510
PER/28/052012
01/05/2012
30/04/2013
7000
15
00504
JL. RAYA LEMAH ABANG DS. MEKAR MUKTI KEC. CIKARANG -89104330
UTARA
17530
PER/28/052012
01/05/2012
30/04/2013
7000
16
00499
-88334541
17510
PER/28/052012
01/05/2012
30/04/2013
7000
17
02812
-89190008
17730
PER/28/052012
01/05/2012
30/04/2013
7000
18
02787
PKM PEBAYURAN
-89150463
17710
PER/28/052012
01/05/2012
30/04/2013
7000
19
02813
PKM SETU II
-82604947
17320
PER/28/052012
01/05/2012
30/04/2013
7000
20
00523
PKM SETU I
-82600333
17320
PER/28/052012
01/05/2012
30/04/2013
7000
21
02814
17330
PER/28/052012
01/05/2012
30/04/2013
7000
22
00494
PKM SRIAMUR
-8921985
17510
PER/28/052012
01/05/2012
30/04/2013
7000
23
00497
-89160352
17630
PER/28/052012
01/05/2012
30/04/2013
7000
24
02803
17520
PER/28/052012
01/05/2012
30/04/2013
7000
25
00522
-89160186
17630
PER/28/052012
01/05/2012
30/04/2013
7000
26
02801
17620
PER/28/052012
01/05/2012
30/04/2013
7000
27
00529
PKM SUKADAMI
17530
PER/28/052012
01/05/2012
30/04/2013
7000
28
02808
PKM SUKAMAHI
JL. RAYA SUKAMAHI KP.CIMAHI DS. SUKAMAHI RT 07/04 KEC. CIKARANG PUSAT
17530
PER/28/052012
01/05/2012
30/04/2013
7000
29
00507
17510
PER/28/052012
01/05/2012
30/04/2013
7000
30
00521
PKM TAMBELANG
17620
PER/28/052012
01/05/2012
30/04/2013
7000
00519
PKM BABELAN I
-89132278
17610
02800
PKM BABELAN II
JL. RAYA BUNI BAKTI NO.11 RT 10/06 DS. BUNI BAKTI KEC.
BABELAN
-89132275
17610
03568
-89180357
17720
00517
PKM CIBARUSAH
-89952659
17340
00495
PKM CIKARANG
17530
02805
17530
00508
02786
02810
10
RI244010
SENIN
UMUM (SHIFT 1)
PKR102001
Halaman :
Tanggal :
127/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
KEC. TAMBELANG
17510
PER/28/052012
01/05/2012
30/04/2013
7000
-88990252
17211
PER/28/052012
01/05/2012
30/04/2013
7000
-89107679
17520
PER/28/052012
01/05/2012
30/04/2013
7000
PKM WANASARI
-8830881
17520
PER/28/052012
01/05/2012
30/04/2013
7000
08071
JL. RAYA TEGAL DANAS RT. 002/005 DS. HEGAR MUKTI KEC. 021-41219342 17510
CIKARANG PUSAT
H. ANTA SUANTA
PER/39/102012
11/10/2012
31/03/2013
7000
36
00567
021-8901318
SAMIDI WIJAYA
PER/11/052012
01/05/2012
30/04/2013
10000
37
00535
JL. RAYA INDUSTRI NO.2 KP. TEGAL GEDE DS. MEKAR MUKTI 021-89835510 17530
CIKARANG UTARA
PER/14/052012
01/05/2012
30/04/2013
14000
38
05079
021-89677085 17530
PER/15/052012
01/05/2012
30/04/2013
14000
39
00563
021-8970524
021-8970524
SAMIDI WIJAYA
PER/12/052012
01/05/2012
30/04/2013
7000
40
06223
JL. RAYA CIBARUSAH KP. POPONCOL RT 02/04 DS. CIBARUSAH 021-51154205 17340
KOTA
AMBAR WIDAWATI
PER/25/052012
01/05/2012
30/04/2013
7000
41
08072
021-89142719 17540
PER/40/102012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT I),
GIGI (SHIFT 1), SALIN (SHIFT
KAMIS, JUM'AT,
1)
SABTU, MINGG
11/10/2012
31/03/2013
7000
42
05880
021-89954434 17330
PER/17/052012
01/05/2012
30/04/2013
14000
43
00526
021-89140241 17540
PER/18/052012
01/05/2012
30/04/2013
7000
44
05500
021-98244176 17530
PER/22/052012
01/05/2012
30/04/2013
10000
45
04887
021-89836243 17530
PER/19/052012
01/05/2012
30/04/2013
15000
46
05054
021-8935937
17530
021-8935937
H. ACH. ZUHUR
PER/13/052012
01/05/2012
30/04/2013
10000
47
00518
KLINIK ANNISA II
021-8976189
17530
021-8976189
PER/16/052012
01/05/2012
30/04/2013
13000
48
04888
021-8937941
17530
PER/20/052012
01/05/2012
30/04/2013
10000
49
06202
021-89115950 17530
PER/23/052012
01/05/2012
30/04/2013
4000
50
04605
021-8935887
021-8935887
PER/26/052012
01/05/2012
30/04/2013
14000
51
06201
021-89952612 17330
PER/21/052012
01/05/2012
30/04/2013
7000
52
06224
KLINIK NESKA
021-46507826 17530
PER/24/052012
01/05/2012
30/04/2013
7000
53
05078
RB. AS-SHOFWAN
17540
PER/11/042008
01/03/2008
28/02/2009
54
05055
RB. KENANGA
17530
PER/14/082007
01/08/2007
31/07/2008
55
00557
021-8902429
17530
PER/27/052012
01/05/2012
30/04/2013
56
05077
RB. ANNISA 3
99999
PER/07/032007
02/03/2007
29/02/2008
57
08074
RS AMANDA
021-8971643
17530
021-8970808
PER/37/102012
11/10/2012
31/03/2013
58
03572
021-8900530
17530
021-8900570
DR. H ROESHADI S
PER/33/082012
01/08/2012
31/01/2013
31
00509
PKM TAMBUN
32
02799
33
02804
34
00536
35
RI244010
021-8900129
17530
17530
17530
v
v
7000
PKR102001
Halaman :
Tanggal :
128/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
59
08075
RS CIKARANG MEDIKA
60
07489
61
08073
62
05076
63
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
PER/38/102012
11/10/2012
31/03/2013
PER/34/082012
01/08/2012
31/01/2013
PER/36/102012
11/10/2012
31/12/2012
021-89952340 17340
021-89722473 17530
RS KARYA MEDIKA
04354
RS MEDIROSSA
021-89833216 17530
021-8934979
H. OMIN BASUNU,SH
PER/31/082012
01/08/2012
31/01/2013
64
05643
021-8904160
17530
021-8904159
PER/32/082012
01/08/2012
31/01/2013
65
06156
021-89840904 17550
PER/31/052012
01/05/2012
30/04/2013
66
05082
APOTEK AS-SYIFA
021-98569002 17211
PER/35/082012
01/09/2012
31/08/2013
67
08076
021-89677085 17530
PER/41/102012
11/10/2012
31/03/2013
021-8904165
99999
021-8903350
68
17530
99999
69
021-8972472
17530
021-8990769
JOHANES POSO
PER/01/012013
29/12/2012
31/12/2013
70
021-8904165
17211
021-8903350
PER/02/012013
01/01/2013
31/12/2013
71
99999
DR. BRILIANTONO MS
RI244010
JUMLAH
TTG
PKR102001
Halaman :
Tanggal :
129/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/41/012013
01/01/2013
31/12/2013
7000
PER/43/012013
01/01/2013
31/12/2013
7000
PER/47/012013
01/01/2013
31/12/2013
7000
PER/46/012013
01/01/2013
31/12/2013
7000
PER/ 51/012013
01/01/2013
31/12/2013
7000
PER/50/012013
01/01/2013
31/12/2013
7000
PER/44/012013
01/01/2013
31/12/2013
7000
PER/39/012013
01/01/2013
31/12/2013
9000
022-5232291
PER/40/012013
01/01/2013
31/12/2013
7000
40262
022-7330181
PER/42/012013
01/01/2013
31/12/2013
7000
022-5979045
40191
022-5979045
KOPERASI PETERNAKAN
BANDUNG SELATAN
PER/36/102012
01/11/2012
31/05/2013
7000
022-6640384
40394
022-6640384
PER/49/012013
01/01/2013
31/12/2013
10000
-081910118171 40296
PER/45/012013
01/01/2013
31/12/2013
7000
05367
RB NORMA MASHITA
022-5943733
40376
PER/48/012013
01/01/2013
31/12/2013
15
06761
JL KIASTRAMANGGALA BALEENDAH
022-5940872
40381
022-5940719
PER/11/012012
01/02/2012
31/12/2012
16
07814
022-5201656
40232
022-5224219
PER/15/032012
01/04/2012
31/12/2012
17
05442
OPTIK KRIDA
022-5431967
40384
022-7333813
HERRY KRIDA
PER/13/012012
01/02/2012
31/12/2012
18
1100000000025 RUMAH SAKIT IMMANUEL (TRAUMA CENTER) JL. KOPO NO 161 KOTA BANDUNG
022-5201051
40234
022-5210195
PER/28/072012
01/07/2012
30/06/2013
03394
BP ALBAR
085-863333599 40921
06111
022-6037679
40115
022-6037679
05313
DR ROSIDAH
022-5943733
40376
DR ROSIDAH
07601
022-85240554 40115
DR RANI BUDIMAN
07986
085-222120500 40121
08002
085-314245518 40115
07198
022-85874343 40385
022-5891313
04305
KLINIK AVIATI
JL KOPO NO 59 BANDUNG
022-5232291
40242
022-5232291
07375
022-5892159
40376
10
06214
022-7330181
11
08093
KLINIK MA AGEUNG
12
07985
13
06718
14
RI244010
v
v
v
v
7000
PKR102001
Halaman :
Tanggal :
130/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
NO IKS
JUMLAH
TTG
PER/26/052012
01/05/2012
30/04/2013
7000
PER/29/052012
01/05/2012
30/04/2013
14000
PER/33/052012
01/05/2012
30/04/2013
7000
PER/20/022012
01/02/2012
31/01/2013
14000
PER/36/052012
01/05/2012
30/04/2013
14000
PER/28/052012
01/05/2012
30/04/2013
7000
PER/18/022012
01/02/2012
31/01/2013
14000
02586
PKM CILEUNGSI
021-8230348
16310
DR HARUMITI RAMLI
02589
021-8671736
16330
021-8671736
DR ISTININGSIH
02595
BANTAR MEDIKA
021-82493557 16310
06492
BP GRACIA
04506
DERA AS-SYIFA
021-8234492
02588
06049
02591
KLINIK AL QOMAR
04858
021-37380717 16330
10
05844
KLINIK AZALIA
021-82409911 16610
11
07038
KLINIK DR DEDI
12
06620
KLINIK DR IRMAN
13
02593
14
06568
15
04859
16
08120
17
POLA PEMBIAYAAN
JAM BUKA
021-8234492
DR IWAN SETIAWAN
-08129327267 16310
DR SAUDY NOORDIN
021-868605772 16964
EDWIN LIMBONG
-33840944
DR NURUL SUBHAN
PER/30/052012
01/05/2012
30/04/2013
8000
PER/38/052012
01/05/2012
30/04/2013
12000
DR KHAIRINA
PER/40/052012
01/05/2012
30/04/2013
7000
16360
-29232696
DR DEDI SYARIF
PER/50/052012
01/05/2012
30/04/2013
14000
16620
081328320391
DR KUSWANI INDRIANTI
PER/49/052012
01/05/2012
30/04/2013
7000
021-82493433 16330
DR HARUMITI RAMLI
PER/31/052012
01/05/2012
30/04/2013
14000
021-8670088
16961
PER/49/052012
01/05/2012
30/04/2013
14000
021-8232791
16330
-27386959
PER/39/052012
01/05/2012
30/04/2013
12000
KLINIK SUTURA
021-29219316 16820
DR.EDRIZAL ANIS
PER/59/112012
01/11/2012
30/10/2013
04857
KLINIK TLAJUNG
021-8675604
16830
087870860178
DR SUMARNI
PER/37/052012
01/05/2012
30/04/2013
12000
18
06050
021-8671056
16964
DR SOEBAGYO WINOTO
PER/19/022012
01/02/2012
31/01/2013
7000
19
05325
PERMATA MEDIKA I
-081310786585 16330
DR EDRIZAL ANIS
PER/47/052012
01/05/2012
30/04/2013
7000
20
02587
021-8234633
16310
PER/27/052012
01/05/2012
30/04/2013
14000
21
03798
POLIKLINIK MEDISTIRA 2
021-8670130
16340
DR SISWARTI ADNAN
PER/34/052012
01/05/2012
30/04/2013
14000
22
02594
ROBBY MEDIKA
021-89930987 16330
021-8670088
ASRINALDI
PER/32/052012
01/05/2012
30/04/2013
14000
23
03888
SUMARNO MEDIKA
021-82497960 16640
DR FEBRI
PER/35/052012
01/05/2012
30/04/2013
14000
24
05152
021-8671736
16310
021-8671736
DR ISTIARTI SURANINGSIH
PER/41/052012
01/05/2012
30/04/2013
25
05528
021-8234492
16820
021-8234492
EKA SETIAWAN
PER/09/01-2008
01/01/2008
31/12/2008
26
04855
RS AL-IKHLAS
99999
H SUPARTO
27
03619
021-82492222 16330
16330
16330
7000
14000
7000
PER/42/052012
01/04/2012
30/04/2013
7000
021-82491331
RI244010
PKR102001
Halaman :
Tanggal :
131/239
15-01-2013
16:22:40
PEMILIK
NO
NO. PPK
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
28
04183
RS MH THAMRIN CILEUNGSI
021-82491332 16330
29
07908
021-8230426
16820
30
04594
APOTEK CILEUNGSI
021-8230088
16310
31
06051
021-32919142 16310
32
03620
33
04184
34
04183
TC RS MH THAMRIN CILEUNGSI
RI244010
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/44/032012
01/03/2012
28/02/2013
PER/52/062012
01/06/2012
31/05/2013
PER/46/052012
01/05/2012
30/04/2013
7000
PER/25/032012
01/03/2012
28/02/2013
7000
7000
7000
021-8235052
16820
021-8231829
021-8231992
DR ABDUL RADJAK
PER/55/092012
01/09/2012
31/08/2013
140000
PKR102001
Halaman :
Tanggal :
132/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
PER/019/042012
01/05/2012
30/04/2013
14000
PER/034/112012
01/12/2012
31/12/2013
14000
PER/023/062012
01/07/2012
30/06/2013
14000
PER/031/072012
01/08/2012
31/01/2013
14000
PER/038/122012
01/01/2013
30/06/2013
14000
PER/030/072012
01/08/2012
31/01/2013
14000
PER/037/122012
01/01/2013
31/12/2013
14000
PER/015/042012
01/05/2012
30/04/2013
14000
PER/016/042012
01/05/2012
30/04/2013
14000
PER/012/032012
01/04/2012
31/03/2013
8000
PER/017/042012
01/05/2012
30/04/2013
10500
PER/032/082012
01/09/2012
28/02/2013
7000
PER/014/042012
01/05/2012
30/04/2013
7000
PER/021/052012
01/06/2012
31/05/2013
7000
PER/032/102012
01/10/2012
31/03/2013
14000
PER/039/122012
01/01/2013
30/06/2013
21000
PER/011/032012
01/04/2012
31/03/2013
14000
PER/022/062012
01/07/2012
30/06/2013
14000
PER/010/032012
01/04/2012
31/03/2013
14000
PER/018/042012
01/05/2012
30/04/2013
14000
06933
BP PERMATA
021-5533314
15211
DR JAMILAH
05943
021-5909766
15211
NANIK ASFIATI
07208
JL PASAR KEMIS RT 02/03 SUKA ASIH KEC PASAR KEMIS KAB TANGERANG
021-5909080
15211
H ACHMAD YUNUS
04675
-98038042
15211
DR HARIYANI
07209
021-59305412 15211
KUNADI
00717
-70203285
15211
DR SULAIMAN
04854
JL GEBANG RAYA NO 30
021-55773345 15211
06930
021-5916255
15211
DR INDRIATI WIDJAJA
06931
021-5900649
15560
DR ANDRI PANGESTU
10
07386
021-5525026
15211
M ISHAK, S.PD
11
06929
021-5527571
15211
12
07491
15211
DR INDERJIT SINGH
13
06173
JL INDUSTRI PASAR KEMIS RT 4/1 KEL GEMBOR KEC PERIUK 021-33837839 15211
TANGERANG
021-5923588
14
05924
AMIDIN
15
08050
15211
16
00721
-59309184
15211
-5320255
KUNADI
17
03858
KLINIK SAHABAT
-71239746
15211
DR. BAMBANG
18
02489
-5917252
15211
DR SULAEMAN
19
00716
15211
DR MURDIYATI
20
06932
021-5913555
15211
21
04988
RB GEBANG MEDIKA
JL. GEBANG
99999
22
04149
RSU AN-NISA
-5525564
15211
-55791563
DR EDIANSYAH, MARS
PER/024/062012
01/07/2012
30/06/2013
23
05830
021-5902229
15211
021-5902223
DR E TRISNO SUSILO
PER/029/072012
01/08/2012
31/07/2013
24
06934
021-5913555
15211
PER/020/042012
01/05/2012
30/04/2013
25
021-5525564
15211
021-55791563
PER/035/122012
01/12/2012
30/11/2013
26
021-5902226
15211
021-5902223
PER/036/122012
01/12/2012
30/11/2013
RI244010
021-98038042 15211
JUMLAH
TTG
70
DR E TRISNO SUSILO
7000
PKR102001
Halaman :
Tanggal :
133/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
06757
BP PERTIWI
021-87922627 16414
04622
BP BHAKTI JAYA
16412
05275
BP MELATI MEDIKA
-87704486
08080
DR DAHLIA
06246
DR IRENE NURSALIM
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
16411
021-94522738 16411
DR MOHAMMAD RIFKI
021-87743157 16413
DR MOHAMMAD RIFKI
06654
16411
DR OPA ROVANA W
07860
DR SALMA
16411
DR SALMA
08079
021-94522738 16411
07853
DRG THESTYANA S
10
05276
KLINIK PEKAPURAN
JL PEKAPURAN NO 1 CIMANGGIS
-021-8740082 16411
-8740825
DR GABY SAPUTRA
11
04224
021-8746538
16411
DR NOVIA MIRALIA
12
07145
021-7775451
16413
DR OTRIALIKA BAHAR
13
06822
16421
DR IRFAN PERDANA
14
04046
021-8746361
16411
IR BUDI W
15
07570
16412
16
08029
16415
17
05281
KLINIK PALSIGUNUNG
JL AKSES UI NO 49 RT 05 RW 04 CIMANGGIS
-8722891
16411
-8722891
18
06869
KLINIK QITA
16423
19
07144
16422
20
05057
021-98529280 16414
21
07480
22
05207
23
05279
24
JUMLAH
TTG
PER/119/122012
01/01/2013
31/12/2013
7000
PER/108/122012
01/01/2013
31/12/2013
14000
PER/124/122012
01/01/2013
31/12/2013
7000
PER/91/102012
01/11/2012
31/10/2013
7000
PER/55/072012
01/08/2012
31/07/2013
7000
PER/120/122012
01/01/2013
31/12/2013
7000
PER/132/122012
01/01/2013
31/12/2013
7000
PER/90/102012
01/11/2012
31/10/2013
7000
PER/133/122012
01/01/2013
31/12/2013
7000
PER/115/122012
01/01/2013
31/12/2013
7000
PER/118/122012
01/01/2013
31/12/2013
7000
PER/110/122012
01/01/2013
31/12/2013
7000
PER/53/072012
01/08/2012
31/07/2013
7000
PER/116/122012
01/01/2013
31/12/2013
7000
DR EVI DEVIYANA
PER/93/102012
01/11/2012
31/10/2013
7000
DR SRI SUGIARTI
PER/81/092012
01/10/2012
01/09/2013
7000
PER/122/122012
01/01/2013
31/12/2013
14000
DR ELIS TIAHESARA,SPAK
PER/92/102012
01/11/2012
31/10/2013
7000
BIDAN YATMIATI
PER/114/122012
01/01/2013
31/12/2013
7000
PER/111/122012
01/01/2013
31/12/2013
3000
0251-8613433 16423
PER/75/082012
01/09/2012
31/08/2013
7000
-7774976
16412
PER/109/122012
01/01/2013
31/12/2013
7000
-7707106
16411
PER/113/122012
01/01/2013
31/12/2013
7000
05280
-8727305
16411
PER/123/122012
01/01/2013
31/12/2013
7000
25
06012
-08161152888 16412
PER/121/122012
01/01/2013
31/12/2013
7000
26
05278
-8747247
PER/117/122012
01/01/2013
31/12/2013
7000
RI244010
16411
DR PUTRI ADRIANI
DR A.D.ARITONANG
PKR102001
Halaman :
Tanggal :
134/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
27
06651
021-8761194
16310
28
06614
16411
29
06663
021-77883905 16434
30
06981
021-7545786
16434
31
04330
32
05328
33
07957
34
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/96/122012
01/01/2013
31/03/2013
7000
PER/54/072012
01/08/2012
31/07/2013
7000
DR SOBARI
PER/95/122012
01/01/2013
31/03/2013
7000
DR TRI MULYATI
PER/112/122012
01/01/2013
31/12/2013
7000
021-98029961 16411
DR TRISNA SETIAWAN
PER/94/122012
01/01/2013
31/03/2013
7000
021-7751505
16412
DR YANI HARYANI
PER/107/122012
01/01/2013
31/12/2013
7000
16411
DR ALEXY OKTOMAN,SPOG,MARS
PER/126/122012
01/01/2013
31/12/2013
04991
CV QUARTA MEDIKA
16422
DR SUKWANTO GAMAL
PER/127/122013
01/01/2013
31/12/2013
35
07146
021-8711517
16422
PER/128/122012
01/01/2013
31/12/2013
36
05058
RB MEDY ASRI
16412
BD HJ SRI MURWATI
PER/34/072007
01/08/2007
31/07/2008
37
06245
RB MEDY ASRI
16412
BD SRI MURWATI
PER/28/072011
01/08/2011
31/07/2012
7000
38
07606
RS CITAMA
021-87985555 16411
PER/125/122012
01/01/2013
31/12/2013
7000
39
07592
021-
16411
021-
PER/98/112012
01/12/2012
31/05/2013
40
07530
RS MEILIA
JL ALTERNATIF CIBUBUR KM 1
021-8444444
16415
PER/86/092012
01/10/2012
30/09/2013
41
03541
RS SENTRA MEDIKA
-8743790
16411
DR NURHAYATI HADI,MARS
PER/129/122013
01/01/2013
30/06/2013
7000
42
05298
RS SIMPANGAN DEPOK
021-8741549
16412
021-8741574
DR WARSITO,MM
PER/103/122012
01/01/2013
30/06/2013
7000
43
03871
RS TUGU IBU
-021-8711693 16411
-021-8711863 ZAKARIA
PER/78/122011
01/01/2012
31/12/2012
7000
44
07809
16411
DR CHAZALI H SITUMORANG
PER/19/032012
01/04/2012
31/03/2013
45
06577
APOTEK CEMPAKA
021-7545786
16423
DR AL BAHRI HUSIN
PER/85/122011
01/01/2012
31/12/2012
46
07773
021-7704044
16417
DRS FAHARUDDIN,APT
PER/15/032012
01/03/2012
28/02/2013
47
06652
APOTIK AL BAROKAH
16414
BD IDA
PER/68/122010
01/01/2011
31/12/2011
48
04559
16411
PER/130/122012
01/01/2013
31/12/2013
49
05375
021-7775415
16414
PER/131/122012
01/01/2013
31/12/2013
50
07181
OPTIK PILLOTE
021-77204341 16412
SUTRIS PRAMONO
PER/21/032012
01/04/2012
31/03/2013
7000
51
04729
OPTIK PRIKASIH
021-77204341 16431
SUTRIS
PER/52/072010
01/08/2010
31/07/2011
7000
52
05674
OPTIK SOCA
16412
ARIEF DARMANSYAH
PER/51/072012
01/08/2012
31/07/2013
53
021-8444444
16411
DR LIRA FEBRI
PER/81/122011+PKS/045/K 01/01/2012
ES/JAMSOSTEK/XI/2011
31/12/2012
RI244010
DR HUSNUL KAMAL
HARI BUKA
PPK II
DR KARLINA
7000
7000
7000
7000
PKR102001
Halaman :
Tanggal :
135/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/10/012013
01/01/2013
31/12/2013
4000
PER/10/012013
01/01/2013
31/12/2013
3500
PER/10/012013
01/01/2013
31/12/2013
3500
H.DADANG,S.IP.M.EPID
PER/10/012013
01/01/2013
31/12/2013
7000
H.DADANG, S.IP.M.EPID
PER/10/012013
01/01/2013
31/12/2013
4100
15211
H.DUDUNG,S.IP.M.EPID
PER/10/012013
01/01/2013
31/12/2013
3500
15211
H.DADANG,SIP,M.EPID
PER/10/012013
01/01/2013
31/12/2013
4000
021-98213148 15417
DRG ROSMAWATI
PER/01/012013
01/01/2013
31/12/2013
7000
KLINIK AMIRA
021-53164794 15211
DR. MURTININGRUM
PER/02/012013
01/01/2013
31/12/2013
7500
04959
021-5397314
PER/08/012013
01/01/2013
31/12/2013
14000
11
04892
021-68064774 15414
PER/03/012013
01/01/2013
31/12/2013
7000
12
06671
021-7421146
15414
DR AYAT RAHAYU,SP.RAD.M.KES
PER/05/012013
01/01/2013
31/12/2013
7000
13
06785
KLINIK MEDIFARMA
021-7413110
15414
021-7413110
DRA YANTHI
HERGIYANTINI,APTH,M.KES
PER/06/012013
01/01/2013
31/12/2013
7000
14
04246
KLINIK RAZAAQ
ANISA MAHARANI
PER/04/012013
01/01/2013
31/12/2013
14000
15
07688
KLINIK SURADITA
021-75790824 15211
DR HJ SITI MURWANI
PER/09/012013
01/01/2013
31/12/2013
3500
16
04304
PUTI HANDIYAH
021-7562156
15211
-5384306
PER/07/012013
01/01/2013
31/12/2013
5000
17
07597
021-7490829
15414
021-7499157
PER/20/062012
01/06/2012
31/12/2012
14000
18
06640
RS IMC BINTARO
021-7456379
15414
021-7450819
PER/16/012012
01/01/2012
31/12/2012
7000
19
06990
RS ISLAM ASSHOBIRIN
021-5384314
15211
021-5374293
DR AYI RAFFIAH,MARS
PER/09/012012
01/01/2012
31/12/2012
20
08006
021-53154447 15414
021-5385062
PER/23/082012
01/08/2012
31/12/2012
7000
21
07598
021-7407421
15414
021-7496346
DR REZA KAMAL,SPOG
PER/22/062012
01/06/2012
31/12/2012
14000
22
07596
021-74706020 15414
PER/21/062012
01/06/2012
31/12/2012
14000
23
06466
021-7498708
15211
021-7498708
PER/11/012012
01/01/2012
31/12/2012
24
06464
021-5372231
15211
021-5372231
DEDI AMHAR,SSI,APT
PER/10/012012
01/01/2012
31/12/2012
25
06465
021-5386924
15211
021-5386924
MELINDA NAPITUPULU,SSI,APT
PER/12/012012
01/01/2012
31/12/2012
06324
PUSKESMAS CIPUTAT
021-74702350 15211
H.DADANG,S.IP.M.EPID
06329
PUSKESMAS JOMBANG
021-74862115 15211
H.DADANG,S.IP.M.EPID
06325
15211
H.DADANG, SIP.M.EPID
06326
PUSKESMAS PAMULANG
021-7445537
15211
06323
06327
021-5372931
06328
PUSKESMAS SERPONG
021-7566045
04303
04736
10
RI244010
15310
PKR102001
Halaman :
Tanggal :
136/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
03224
PUSKESMAS KALIWUNGU
KALIWUNGU KENDAL
50511
01362
BP MULIA HUSADA I
50661
01341
50661
05384
BP "NUR AINI"
50511
01313
BP CARAKALIMA
07414
BP CITRA KALIWUNGU
01344
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/29/012013
01/01/2013
31/12/2013
PER/31/012013
01/01/2013
31/12/2013
8000
PER/42/012013
01/01/2013
31/12/2013
7200
PER/47/012013
01/01/2013
31/12/2013
7000
50661
PER/53/012013
01/01/2013
31/12/2013
10090
50511
PER/57/012013
01/01/2013
31/12/2013
7000
50661
PER/39/012013
01/01/2013
31/12/2013
10500
03910
50661
PER/38/012013
01/01/2013
31/12/2013
7000
01323
50661
PER/31/012012
01/01/2012
31/12/2012
7000
10
01350
BP EKA SAKTI
JL MERAK NO 2 A
50661
PER/36//012013
01/01/2013
31/12/2013
7000
11
01353
BP HARAPAN PRIMA
50661
PER/33/012013
01/01/2013
31/12/2013
7000
12
01315
BP HARAPAN RAHARJA
50661
PER/34/012013
01/01/2013
31/12/2013
7000
13
01316
BP HARAPAN SEJAHTERA
50661
PER/56/012013
01/01/2013
31/12/2013
10000
14
03912
BP KUSUMA MEDIKA
50661
PER/50/012013
01/01/2013
31/12/2013
7000
15
01340
BP MULIA HUSADA II
50661
PER/32/012013
01/01/2013
31/12/2013
7000
16
07888
50141
PER/58/012013
01/01/2013
31/12/2013
5000
17
07889
51351
PER/59/012013
01/01/2013
31/12/2013
200
18
03490
BP PAMULARSIH
50661
PER/46/012013
01/01/2013
31/12/2013
7000
19
01322
BP PLAMONGAN
50661
PER/45/012013
01/01/2013
31/12/2013
7000
20
94572
BP PUCANG ANOM
50661
PER/54/012013
01/01/2013
31/12/2013
7000
21
01338
50661
PER/51/012013
01/01/2013
31/12/2013
7000
22
03222
BP SETIA HUSADA I
50661
PER/40/012013
01/01/2013
31/12/2013
7000
23
03489
BP SETIA HUSADA II
50661
PER/41/012013
01/01/2013
31/12/2013
7000
24
01332
BP SETIABUDI
50661
PER/35/012013
01/01/2013
31/12/2013
10000
RI244010
PKR102001
Halaman :
Tanggal :
137/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/43/012013
01/01/2013
31/12/2013
10000
PER/44/012013
01/01/2013
31/12/2013
11000
PER/52/012013
01/01/2013
31/12/2013
7000
PER/48/012013
01/01/2013
31/12/2013
7000
PER/09/012013
01/01/2013
31/12/2013
10000
50661
PER/77/012013
01/01/2013
31/12/2013
7000
50661
PER/04/012013
01/01/2013
31/12/2013
7000
50511
PER/15/012013
01/01/2013
31/12/2013
7000
50661
PER/10/012013
01/01/2013
31/12/2013
7000
01317
DR ELANG SUMAMBAR
JL DR SOETOMO NO 3 SEMARANG
50661
PER/02/012013
01/01/2013
31/12/2013
7000
35
04735
DR ERNA DWININGRUM
50511
PER/11/012013
01/01/2013
31/12/2013
7000
36
07044
DR H SUWINDI
50139
PER/13/012013
01/01/2013
31/12/2013
5000
37
01314
DR INDRAWATI
50661
PER/08/012013
01/01/2013
31/12/2013
7000
38
01334
DR INGGRID TANESHA
50661
PER/01/012013
01/01/2013
31/12/2013
7036
39
01339
DR ITA HANDOKO
50661
PER/07/012013
01/01/2013
31/12/2013
7000
40
01311
DR KUSMIYATI CAHYONO
50661
PER/16/012013
01/01/2013
31/12/2013
7000
41
05383
50511
PER/12/012013
01/01/2013
31/12/2013
7000
42
01325
50661
PER/03/012013
01/01/2013
31/12/2013
7000
43
05266
DR NUGROHO
50661
PER/22/2013
01/01/2013
31/12/2013
7000
44
07046
51351
PER/17/012013
01/01/2013
31/12/2013
5000
45
03223
DR RAHMAT BUDI S
JL KEDUMUNDU RAYA NO 17
50661
PER/05/012013
01/01/2013
31/12/2013
7000
46
07713
DR RENI ERVINA
50141
PER/19/012013
01/01/2013
31/12/2013
7000
47
07045
DR SITI MUSRI'AH
51351
PER/18/012013
01/01/2013
31/12/2013
5000
48
01319
50661
PER/20/012013
01/01/2013
31/12/2013
7000
25
01345
50661
26
01348
50661
27
03221
BP UMMU ROHMAH
50661
28
05175
51351
29
04694
50664
30
01318
DR AGUS PRIBADI
DESA LIMBANGAN RT 01 RW 06
31
03911
DR ARIAWAN SETIADI
32
06179
DR BOEDI SETIAWAN
33
05040
34
RI244010
DR HANA SETIALINGSIH
PKR102001
Halaman :
Tanggal :
138/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/21/012013
01/01/2013
31/12/2013
7000
PER/06/012013
01/01/2013
31/12/2013
7000
PER/14/012013
01/01/2013
31/12/2013
7000
PER/26/012012
01/01/2013
31/12/2013
31000
PER/25/012013
01/01/2013
31/12/2013
32500
50111
PER/78/012013
01/01/2013
31/12/2013
50661
PER/24/012013
01/01/2013
31/12/2013
35000
50661
PER/28/012012
01/01/2012
31/12/2012
31000
DRG SUTANTI
JL. MADUKORO I NO . 9 A
50661
PER/23/012013
01/01/2013
31/12/2013
35789
01359
50661
PER/27/012012
01/01/2013
31/12/2013
31500
59
06180
50511
PER/28/012013
01/01/2013
31/12/2013
10520
60
08094
50111
PER/94/092012
01/09/2012
30/08/2013
61
03663
50661
PER/55/012013
01/01/2013
31/12/2013
7000
62
07691
50141
PER/30/012013
01/01/2013
31/12/2013
30000
63
01333
KLINIK SELARAS
50661
PER/49/012013
01/01/2013
31/12/2013
7000
64
04754
7000
65
94841
7000
66
05270
JL DR SOETOMO NO 17 SEMARANG
-024-3555744 50661
67
07893
RS PERMATA BUNDA
50139
68
05268
RSU DR KARYADI
JL DR SOETOMO 16 SEMARANG
50661
69
01365
JL LAUT NO 21 KENDAL
51351
70
01364
71
05681
RS PERMATA MEDIKA
72
04420
73
05269
74
04118
49
04106
50661
50
01324
DR YETI NASTUTI
50661
51
06112
50511
52
03662
JL DR CIPTO NO 78
50661
53
03492
50661
54
08023
55
01356
DRG GUNAWAN
JL DR SOETOMO NO 3 SEMARANG
56
03635
57
01360
58
RI244010
v
v
250
200
7000
PER/67/012012
01/01/2012
31/12/2012
PER/81/042012
01/04/2012
31/12/2012
PER/70/012011
01/01/2012
31/12/2012
7000
PER/66/012012
01/01/2012
31/12/2012
7000
50661
PER/65/012012
01/01/2012
31/12/2012
7000
024-7625005
50511
024-7621733
PER/69/072012
01/07/2012
30/06/2013
50661
PER/68/012012
01/01/2012
31/12/2012
7000
-024-7605378 50661
PER/64/012012
01/01/2012
31/12/2012
7000
APOTIK BEDIKARI
JL DR SOETOMO NO 16 SEMARANG
7000
PKR102001
Halaman :
Tanggal :
139/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
75
05271
APOTIK BERDIKARI
JL DR SOETOMO SEMARANG
-024-8413993
76
05272
OPTIK INTERNASIONAL
JL PANDANARAN BLOK V NO 6
-024-8412309 50661
PER/62/012013
01/01/2013
31/12/2013
7000
77
05274
OPTIK MONALISA
50661
PER/63/012013
01/01/2013
31/12/2013
7000
78
04023
OPTIK PANDANARAN
50661
PER/61/012013
01/01/2013
31/12/2013
7000
79
07890
50141
PER/66/012013
01/01/2013
31/12/2013
80
01369
OPTIK SA ISMAIL
-024-3550890 50661
PER/60/012013
01/01/2013
31/12/2013
81
07892
51351
PER/65/012013
01/01/2013
31/12/2013
82
06689
OPTIK VALLA
50141
PER/64/012013
01/01/2013
31/12/2013
83
07891
WAHYU OPTIK
51351
PER/67/012013
01/01/2013
31/12/2013
84
04107
50661
PER/71/012012
01/07/2012
30/06/2013
RI244010
7000
7000
PKR102001
Halaman :
Tanggal :
140/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
07220
0815-67888990 89241
PT KERETA API
07101
0271-6812264 57782
PEMKAB KARANGANYAR
05124
57251
06127
0271-495673
57752
0271-495673
PEMKAB KARANGANYAR
07411
01409
0271-7922313 00000
DR SARWASTUTI HENDRADEWI
07409
BP KARUNIA HUSADA
0271-668382
89241
BP KARUNIA HUSADA
07943
BP MITRA SEHAT
0271-7019276 57155
DR AULIA
06711
BP NGESTI HUSADAJATI
0271-853796
89241
10
06105
DR AGIL PRIAMBODO
0271-7686385 57752
11
06818
DR ANY SUSILOWATI
12
06716
13
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/167/112012
01/11/2012
31/10/2013
7000
PER/09/022012
01/02/2012
31/01/2013
10000
PER/155/092012
01/09/2012
31/08/2013
7000
PER/04/012012
01/01/2012
31/12/2012
8000
PER/128/072012
01/07/2012
30/06/2013
10000
PER/90/0720112
01/07/2012
30/06/2013
15000
PER/127/072012
01/07/2012
30/06/2013
40000
PER/36/072012
01/07/2012
30/06/2013
DR DEVI
PER/122/072012
01/07/2012
30/06/2013
10000
DR AGIL PRIAMBODO
PER/150/092012
01/09/2012
31/08/2013
7000
DR ANY SUSILOWATI
PER/151/092012
01/09/2012
31/08/2013
20000
DR ARY PARDIYANTO
DR ARY PARDIYANTO
PER/126/072012
01/07/2012
30/06/2013
10000
01389
DR ASTUTI INDRAHAYUNI
00000
DR ASTUTI INDRAHAYUNI
PER/92/072012
01/07/2012
30/06/2013
7000
14
01406
DR BUDI HARTOYO
-08122982917 57752
DR BUDI HARTOYO
PER/93/072012
01/07/2012
30/06/2013
7000
15
01415
DR DEWI BAROTO
08122-976886 00000
DR DEWI BAROTO
PER/94/072012
01/07/2012
30/06/2013
7000
16
06705
DR DEWI KOMALASARI
0818-04481927 57762
DR DEWI KOMALASARI
PER/120/072012
01/07/2012
30/06/2013
10000
17
04904
0817-2837997 57147
PER/162/102012
01/10/2012
30/09/2013
7000
18
05870
0812-1584249 57252
PER/15/032012
01/03/2012
28/02/2013
7000
19
06593
-08192274875 89241
PER/20/042012
01/04/2012
31/03/2013
10000
20
06712
08572-8247933 57171
PER/123/072012
01/07/2012
30/06/2013
10000
21
06531
DR GUNAWAN
0813-93341478 57792
DR GUNAWAN
PER/18/032012
01/03/2012
28/02/2013
20000
22
06713
DR H SUWARDI
0813-29593636 57691
DR H SUWARDI
PER/001/012013
01/01/2013
31/12/2013
10000
23
01404
DR H TYAS S DHARMOHASTONO
-0271720669
00000
DR H TYAS S DHARMOHASTONO
081329528726
PER/95/072012
01/07/2012
30/06/2013
7000
24
01401
DR HARI PURNOMO
-0271780065
00000
PER/97/072012
01/07/2012
30/06/2013
7000
RI244010
DR HARI PURNOMO
10000
PKR102001
Halaman :
Tanggal :
141/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/96/072012
01/07/2012
30/06/2013
7000
PER/16/032012
01/03/2012
28/02/2013
7000
PER/99/072012
01/07/2012
30/06/2013
7000
PER/12/022012
01/02/2012
31/01/2013
10000
-085642369220 00000
DR INDARTO
PER/100/072012
01/07/2012
30/06/2013
7000
-0271715712
89241
DR KOESMEDI
PER/102/072012
01/07/2012
30/06/2013
7000
DR KUSWANDJANA
-081393411488 00000
DR KUSWANDJANA
PER/103/072012
01/07/2012
30/06/2013
7000
01384
DR LENY ROSMA
-0271732173
00000
DR LENY ROSMA
PER/91/072012
01/07/2012
30/06/2013
7000
33
01412
DR MINTARSIH TANTOWI
-0816672309
00000
DR MINTARSIH TANTOWI
PER/104/072012
01/07/2012
30/06/2013
7000
34
03293
DR ML CHRISTIJANA
-0816675567
00000
DR ML CHRISTIJANA
PER/105/072012
01/07/2012
30/06/2013
7000
35
01416
DR MUTAHID SUKORO
0271-822059
00000
DR MUTAHID SUKORO
PER/106/072012
01/07/2012
30/06/2013
7000
36
01387
DR NANA HOEMARDEWI
-08122971168 00000
DR NANA HOEMARDEWI
PER/107/072012
01/07/2012
30/06/2013
7000
37
01402
DR NANIEK DARWATI S
-0271722297
PER/98/072012
01/07/2012
30/06/2013
7000
38
02643
DR NETTY TRIWAHYUNI
0271-7000161 00000
DR NETTY TRIWAHYUNI
PER/108/072012
01/07/2012
30/06/2013
7000
39
06700
DR NOOR DINIYAH
0815-48747376 57373
DR NOOR DINIYAH
PER/118/072012
01/07/2012
30/06/2013
10000
40
07516
DR NOORDINIYAH 2
0815-48747376 57352
DR NOORDINIYAH
PER/149/092012
01/09/2012
31/08/2013
1000
41
01394
DR NUR BAKDIYADI
-08122612426 00000
DR NUR BAKDIYADI
PER/110/072012
01/07/2012
30/06/2013
7000
42
01405
DR NUR YULIANTO
-0816676967
57752
DR NUR YULIANTO
PER/109/072012
01/07/2012
30/06/2013
7000
43
01393
DR NURUL HUDA
-0811285664
57554
DR NURUL HUDA
PER/111/072012
01/07/2012
30/06/2013
7000
44
04348
DR RINI PALUPI
JL A YANI NO 36 WONIGIRI
0273-322322
00000
DR RINI PALUPI
PER/25/052012
01/05/2012
30/04/2013
7000
45
01385
DR SAMEKTO SUWANDI
-085728947046 00000
DR SAMEKTO SUWANDI
PER/112/072012
01/07/2012
30/06/2013
7000
46
07944
DR SRI MULYANI
0821-34959888 57155
DR SRI MULYANI
PER/38/072012
01/07/2012
30/06/2013
10000
47
01414
DR SRIYONO
-08122976387 00000
DR SRIYONO
PER/113/072012
01/07/2012
30/06/2013
7000
48
01392
DR SUNINTO BUJO H
-0272552875
DR SUNINTO BUJO H
PER/114/072012
01/07/2012
30/06/2013
7000
25
01390
DR HARJANTO MS
-08164272627 00000
DR HARJANTO MS
26
05141
DR HENDRA ISTIARSO
0813-29078972 57352
DR HENDRA ISTIARSO
27
03692
-081393366111 00000
28
06240
0856-2823617 57752
29
02648
DR INDARTO
30
01399
DR KOESMEDI
31
01391
32
RI244010
00000
00000
PKR102001
Halaman :
Tanggal :
142/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/19/032012
01/03/2012
28/02/2013
20000
PER/115/072012
01/07/2012
30/06/2013
7000
DR UMI ARIFAH
PER/116/072012
01/07/2012
30/06/2013
7000
PER/21/042012
01/04/2012
31/03/2013
7000
08122-649035 57138
PER/121/072012
01/07/2012
30/06/2013
20000
0273-321577
57652
PER/130/072012
01/07/2012
30/06/2013
0858-67051444 57373
PER/119/072012
01/07/2012
30/06/2013
10000
08014
DRG. MUJIYATI
0817-9458734 57251
DRG. MUJIYATI
GIGI (SHIFT 1)
PER/152/092012
01/09/2012
31/08/2013
7000
57
06715
0874-2917245 50378
PER/125/072012
01/07/2012
30/06/2013
10000
58
07945
JL BAWEAN NO 14 RT 03 RW 01
08564-7274637 57511
PER/37/072012
01/07/2012
30/06/2013
59
03802
KLINIK ANANDA
-08122644786 00000
DR KARTIKA DAMAYANTI
PER/101/072012
01/07/2012
30/06/2013
7000
60
02647
-0271718454
00000
DR H SOEWOTO
PER/117/072012
01/07/2012
30/06/2013
7000
61
06714
0271-656903
57134
YYS RS TRIHARSI
PER/124/072012
01/07/2012
30/06/2013
10000
62
07410
NGARJOSARI RT 02 RW 02 POPONGAN
0271-8023491 57752
PER/129/072012
01/07/2012
30/06/2013
10000
63
06710
08564-7167053 89241
PER/139/072012
01/07/2012
30/06/2013
20000
64
01417
RSU DR MOEWARDI
0271-634634
00000
0271-637412
PER/02/012012
01/01/2012
31/12/2012
7000
65
07350
JL A YANI 40 WONOGIRI
0273-321042
57661
0273-321008
PEMKAB WONOGIRI
PER/35/062012
01/06/2012
31/05/2013
20000
66
05067
0271-891078
57251
PEMKAB SRAGEN
PER/138/072012
01/07/2012
30/06/2013
70
67
05962
57752
PER/89/092012
01/09/2012
31/08/2013
7000
68
01418
0271-495673
12345
0271-495673
PEMKAB KARANGANYAR
PER/03/012012
01/01/2012
31/12/2012
7000
69
08015
0271-620220
57562
0271-622555
70
04756
RS DR OEN SURAKARTA
0271-643139
57128
71
01420
0271-633313
00000
0271-639402
PT KIMIA FARMA
72
03805
0271-733644
00000
0271-733644
73
02646
0271-637883
00000
0271-893494
74
06253
0271-714455
89241
DR DYAH ANGGRAENI
49
06529
DR SURAWIJAYA BK
0271-653697
89241
DR SURAWIJAYA BK
50
01408
DR TRISMIYANTO
0812-26126795 57473
DR TRISMIYANTO
51
01398
DR UMI ARIFAH
-08122601843 00000
52
05886
0271-620828
57554
53
06709
54
07412
55
06701
56
v
v
v
v
20000
10000
PER/153/092012
01/09/2012
31/08/2013
PER/137/0720112
01/07/2012
30/06/2013
PER/05/012012
01/01/2012
31/12/2012
7000
PER/10/022012
01/02/2012
31/01/2013
7000
PER/11/012012
01/02/2012
31/01/2013
7000
PER/89/062012
01/06/2012
31/05/2013
0271-8099455
RI244010
PKR102001
Halaman :
Tanggal :
143/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/95/092012
01/09/2012
31/08/2013
7000
PER/06/012012
01/01/2012
31/12/2012
7000
PER/140/082012
01/08/2012
31/07/2013
0271-714058
PER/144/082012
01/08/2012
31/07/2013
89241
PER/145/082012
01/08/2012
31/07/2013
0271-643139
89241
0271-660935
PER/142/082012
01/08/2012
31/07/2013
0271-714422
57116
PER/146/082012
01/08/2012
31/07/2013
1100000000032 RS KUSTATI
0271-643013
89241
0271-634823
PER/143/082012
01/08/2012
31/07/2013
JL A YANI 1-2
0271-712077
89241
PER/141/082012
01/08/2012
31/07/2013
75
05885
0271-727886
89241
76
01429
JL HONGGOWONGSO NO 79 SURAKARTA
0271-662004
57139
77
0271-825812
57752
78
0271-714458
57155
79
0271-634634
80
81
82
83
RI244010
AGUS WIDJAYA
PKR102001
Halaman :
Tanggal :
144/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/05/012013
01/01/2013
31/12/2013
18500
PER/32/012013
01/01/2013
31/12/2013
7000
PER/29/012013
01/01/2013
31/12/2013
7000
PER/41.2/112012
01/11/2012
31/12/2013
3500
PER/41.3/112012
01/11/2012
31/12/2013
3500
DR FRIDA ERIYANTONO
PER/41.1/112012
01/11/2012
31/12/2013
3500
PER/41.4/112012
01/11/2012
31/12/2013
3500
-0282-542270 53223
PER/28/012013
01/01/2013
31/12/2013
7000
JL S PARMAN NO 9 CILACAP
-0282-533943 53222
TANTRI RINUKTI
PER/06/012013
01/01/2013
31/12/2013
7000
BP NAYAKA
-0282-532149 53222
RUKMINI
PER/02/012013
01/01/2013
31/12/2013
37000
05318
0282-494993
53222
DR WIYANA SALMAN
PER/19/012013
01/01/2013
31/12/2013
8000
12
05951
DR AGUS SAPARIYANTO
-0816695028
54352
DR AGUS SAPARIYANTO
PER/22/012013
01/01/2013
31/12/2013
7000
13
05435
DR CHAIRUL MARWAN
-081327063660 53222
DR CHAIRUL MARWAN
PER/18/012013
01/01/2013
31/12/2013
8000
14
01439
DR CHOZIN SUNGAIDI
-081327089799 53252
DR CHOSIN SUNGAIDI
PER/13/012013
01/01/2013
31/12/2013
7000
15
03971
DR EKO PRIYONO
JL RAJIMAN NO 3 CILACAP
0282-542886
53222
DR EKO PRIYONO
PER/04/012013
01/01/2013
31/12/2013
7000
16
07463
-087823003810 53252
PER/35/012013
01/01/2013
31/12/2013
7000
17
03880
DR H MUJIASIH
-08122942847 53223
DR HJ MUJIASIH
PER/12/012013
01/01/2013
31/12/2013
7000
18
01432
DR HA SOEMALI M KES
JL DR SUTOMO NO 39/370
-0282-531260 53222
DR HA SOEMALI M KES
PER/03/012013
01/01/2013
31/12/2013
7000
19
01438
-822815216
53232
PER/15/012013
01/01/2013
31/12/2013
7000
20
05952
DS PLARANGAN RT 02 RW 01 KARANGANYAR
-081328009594 54352
DR HJ YOHANITA RINI K
PER/23/012013
01/01/2013
31/12/2013
7000
21
01433
DR ISKAK NURSALIM
-0280-621463 53222
DR ISHAK NURSALIM
PER/11/012013
01/01/2013
31/12/2013
7000
22
07465
DR LANNY ALIANA
-087837698777 54391
DR LANNY ALIANA
PER/36/012013
01/01/2013
31/12/2013
23
01437
DR RIA R ISKAK
-0280-621463 53252
DR RIA R SIMBUNG
PER/16/012013
01/01/2013
31/12/2013
7000
24
03973
DR SISWATI MKES
DR SISWATI M KES
PER/07/012013
01/01/2013
31/12/2013
7000
25
05953
DR SUPRAPTI HARTINI
JL VETERAN NO 18 KEBUMEN
54352
DR SUPRAPTI HARTINI
PER/24/012013
01/01/2013
31/12/2013
7000
01452
BP ANGKATAN LAUT
JL WIRATNO NO 33 CILACAP
-0282-533983 53223
06720
BP POSKES DETASEMEN
-08158849099 53223
03975
0282-534238
53222
08136
PUSKESMAS BANTARSARI
0280-6260827 53281
TULUS YUWANI
08137
PUSKESMAS GANDRUNGMANGU I
0280-6260618 53283
DR H BUDI PRAYOGA
08135
PUSKESMAS KAWUNGANTEN
0282-611867
53253
08138
PUSKESMAS SIDAREJA
0280-523118
53261
01444
01442
10
01451
11
RI244010
-0811262154
3500
PKR102001
Halaman :
Tanggal :
145/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
26
01440
DR TAUFIK HIDAYAT
-08122999550 53253
DR TAUFIK HIDAYAT
27
07464
DR TAUFIK WIJAYANTO
-081804563956 54382
DR TAUFIK WIJAYANTO
28
01430
DR TUTUK S M KES
-0282-541739 53222
29
05950
DR USODO
-08122663498 54352
30
07517
DR YENI RATNAWATI
31
03974
DR YUYUNG
32
07522
33
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/14/012013
01/01/2013
31/12/2013
PER/37/012013
01/01/2013
31/12/2013
DR TUTUK S M KES
PER/01/012013
01/01/2013
31/12/2013
8425
DR USODO
PER/21/012013
01/01/2013
31/12/2013
7000
-08156571277 54473
DR YENI RATNAWATI
PER/43/012013
01/01/2013
31/12/2013
0282-533705
53222
DR YUYUNG BUDIWASKITO
PER/08/012013
01/01/2013
31/12/2013
JL RAYA JERUK LEGI RT 006 RW 003 JERUK LEGI WETAN KEC. -081228844533 53252
JERUK LEGI
PER/41/012013
01/01/2013
31/12/2013
15000
07466
-087737779006 54352
PER/42/012013
01/01/2013
31/12/2013
15000
34
05959
JL KOMPENI NO 25 CILACAP
53222
RUKMINI
SELASA, KAMIS
GIGI (SHIFT 1)
PER/25/012013
01/01/2013
31/12/2013
7000
35
08134
0282-5501687 53272
PER/42/122012
01/12/2012
31/12/2013
21000
36
05319
53222
DR WIYANA SALMAN
PER/20/012013
01/01/2013
31/12/2013
7000
37
06058
RB UMMI
53222
NURFADILAH AM.KEB
PER/31/012013
01/01/2013
31/12/2013
7000
38
06199
54352
PER/30/012013
01/01/2013
31/12/2013
39
01445
RSU CILACAP
0282-535233
53223
DR CHOZIN SUNGAIDI
PER/17/012013
01/01/2013
31/12/2013
40
07518
RSUD MAJENANG
0280-621012
53257
0280-621519
PER/38/012013
01/01/2013
31/12/2013
41
06198
54352
PER/33/012013
01/01/2013
31/12/2013
8000
42
05590
JL A YANI NO 38
53222
DR LEMI ROSMINI
PER/34/012013
01/01/2013
31/12/2013
8000
43
01447
-0282-535233 53222
DR SISWATI M KES
PER/26/012013
01/01/2013
31/12/2013
15000
44
07467
0282-533018
53223
PER/39/012013
01/01/2013
31/12/2013
14000
45
07468
ASEP OPTIK
-081391592345 53232
ASEP SAEFULLOH
PER/40/012013
01/01/2013
31/12/2013
46
01449
-0282-533990 53223
ARDIYANTO SANTOSO
PER/10/012013
01/01/2013
31/12/2013
7000
47
01450
OPTIK MANDIRI
JL S PARMAN NO 48 CILACAP
-0282-533840 53222
FX PUTRANTO BU SPD
PER/09/012013
01/01/2013
31/12/2013
7000
48
JL GATOT SUBROTO NO 28
0282-533010
PER/27/012013
01/01/2013
31/12/2013
RI244010
53222
v
v
7000
3500
7000
8000
15000
7000
PKR102001
Halaman :
Tanggal :
146/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
07294
04841
55652
01483
-0274-868437 55584
01486
55761
03505
JL WIROSABAN 1 YOGYAKARTA
55232
01461
BP ISTIAZAH
-0274-7182338 55791
07476
BP LARAS HATI
0274-8359333 55711
03752
-08121577253 55871
MUHAMADDIYAH
07329
BP RB WIDURI
0274-867363
55511
HJ SUDARIYAH
10
04839
0274-774876
55652
11
07330
0274-7112527 55791
12
03724
DR FAUZAN
-0274-441506 55711
DR FAUZAN
13
03789
DR G ANUNG TRIHADI
-08122774574 55711
DR G ANUNG TRIHADI
14
01469
0274-519670
0274-518223
15
07477
0274-4999679 55515
DR WISNU
16
08090
HARMONY CLINIC
GENDENG GK IV/969
0274-587571
55225
DR RR SRI WAHYUNI
ERNANINGSIH
17
07291
-08122954630 55581
18
08089
0274-7124580 55663
19
07611
JL KALIURANG KM 9.3
0274-882702
55581
IR H IWAN GUNAWAN
20
01471
KLINIK DR SARDJOKO
-0274-896142 55551
SARDJOKO DR
21
07293
0274-9138011 55141
22
07612
-08156882098 55711
DR THERESIA RIAWATI
23
04445
KLINIK MATAHARI
0274-4462393 55563
DR BASARIYANTI
24
01458
-0274-382496 52233
DR NIKEN PALUPI
25
07613
JL PURWOWINOTO PENGASIH RT 07 RW 02 RT 07 RW 02
KULONPROGO
-085868190677 55652
DR SALAMAH
26
01454
0274-542658
RI244010
55222
55121
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/80/122012
01/01/2013
31/12/2013
PER/79/122009-GIGI
01/01/2010
31/12/2010
7000
PER/1168/122010
01/01/2011
31/12/2011
20000
PER/1169/122010
01/01/2011
31/12/2011
20000
PER/02/012011
01/01/2011
31/12/2011
10000
PER/83/122012
01/01/2013
31/12/2013
7000
PER/84/122012
01/01/2013
31/12/2013
14000
PER/91/122012
01/01/2013
31/12/2013
7000
PER/72/122012
01/01/2013
31/12/2013
14000
PER/78/122012
01/01/2013
31/12/2013
7200
PER/86/122012
01/01/2013
31/12/2013
14000
PER/85/122012
01/01/2013
31/12/2013
3500
PER/92/122012
01/01/2013
31/12/2013
7000
PER/87/122012
01/01/2013
31/12/2013
14000
PER/77/122012
01/01/2013
31/12/2013
7000
PER/43/102012
01/11/2012
31/12/2013
7000
PER/95/122012
01/01/2013
31/12/2013
7000
PER/97/122012
01/01/2013
31/12/2013
7000
PER/94/122012
01/01/2013
31/12/2013
14000
PER/76/122012
01/01/2013
31/12/2013
7000
PER/89/122012
01/01/2013
31/12/2013
7000
PER/81/122012
01/01/2013
31/12/2013
14000
PER/74/122012
01/01/2013
31/12/2013
14000
PER/82/122012
01/01/2013
31/12/2013
14000
PER/79/122012
01/01/2013
31/12/2013
14000
PER/71/122012
01/01/2013
31/12/2013
21000
PKR102001
Halaman :
Tanggal :
147/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
SABTU, MINGG
27
04444
KLINIK SWA
0274-7485660 55511
DR ERITA
28
05835
KLINIK WAHYUNI
0274-7166057 55592
MS WAHYUNI
29
01465
KUMALASARI DR
-08122781636 55571
DR KUMALASARI
30
01453
-0274-372176 55172
0274-379212
31
01455
POLIKLINIK GADING
-0274-375396 55132
32
01463
SUWARDI DR MKES
-08122957388 55552
DR SUWARDI
33
07290
YEZIO DENTAL
0274-4398419 55511
34
02635
BAMBANG HARYATNO DR
35
03220
RSU DR SARDJITO
-0274-587333 55562
36
03504
-0274868437
55511
37
03665
0274-563153
55714
38
03217
39
04840
RSUD WATES
40
07614
41
PER/96/122012
01/01/2013
31/12/2013
14000
PER/70/122012
01/01/2013
31/12/2013
7000
PER/75/122012
01/01/2013
31/12/2013
7000
PER/88/122012
01/01/2013
31/12/2013
7000
PER/90/122012
01/01/2013
31/12/2013
14000
PER/73/122012
01/01/2013
31/12/2013
7000
PER/93/122012
01/01/2013
31/12/2013
4500
PER/03/022012
01/03/2012
31/12/2012
7000
PER/1175/122010
01/01/2011
30/12/2011
7000
0274-512368
01/05/2012
31/12/2012
20000
-0274-371195 55192
01/03/2012
31/12/2012
7000
55652
PER/142/122011
01/01/2012
31/12/2012
7000
RS CONDONG CATUR
0274-887494
55514
PER/80/122111
01/01/2012
31/12/2012
07618
RS PANTI NUGROHO
JL KALIURANG KM 17
0274-895186
55582
PER/85/122011
01/01/2012
31/12/2012
7000
42
07648
0274-368238
55711
0274-367437
PER/89/122011
01/01/2012
31/12/2012
10000
43
07620
RS PURI HUSADA
0274-867270
55581
PER/88/122011
01/01/2012
31/12/2012
7000
44
07615
RS QUEEN LATIFA
0274-581402
55292
PER/81/122011
01/01/2012
31/12/2012
7000
45
07070
RS RAJAWALI CITRA
01/01/2012
31/12/2012
7000
46
07619
0274-7494522 55663
PER/82/122011
01/01/2012
31/12/2012
7000
47
07069
0274-498000
55571
0274-498464
PROF.DR.DR.H. LAMSUDIN
01/01/2012
31/12/2012
7000
48
01487
0274-515259
55552
0274-515259
PT KIMIA FARMA
PER/143/122011
01/01/2012
31/12/2012
7000
49
07286
APOTEK UGM
JL PROF SARDJITO 25
0274-550783
55223
0274-547564
UGM
PER/144/122011
01/01/2012
31/12/2012
7000
50
04463
AKUR OPTIK
JL URIP SUMOHARJO 71
0274-7187996 55222
H M ALWY
PER/138/122011
01/01/2012
31/12/2012
7000
51
04443
-367215
55711
-7407467
CHOTIJAH
PER/139/122011
01/01/2012
31/12/2012
7000
52
07284
OPTIK ARIF
0274-374591
52233
PER/141/122011
01/01/2012
31/12/2012
2000
53
03753
OPTIK MARLIN
0274-565350
55223
PER/90/122011
01/01/2012
31/12/2012
7000
54
05472
OPTIK PRANOTO
JL C SIMANJUNTAK 6
0274-565350
55223
0274-7477690 H PRANOTO
PER/137/122011
01/01/2012
31/12/2012
DR BAMBANG HARYATNO
YAY MUHAMMADIYAH
PT MARLIN SOLATAMA
v
v
RI244010
PKR102001
Halaman :
Tanggal :
148/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
55
07283
OPTIK PUAS
0274-865326
56
05262
SUKSESS OPTIK
JL GANDEKAN LOR 90
-0274-562703 55133
57
07621
JL ATMOSUKARTO NO 4
0274-563656
58
07622
0274-557722
RI244010
RS
APT
MUHAMMAD SYAIFULLAH
55224
55224
CV HI LAB
55512
HARI BUKA
PPK II
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/140/122011
01/01/2012
31/12/2012
2000
PER/136/122011
01/01/2012
31/12/2012
7000
01/01/2012
31/12/2012
40000
PER/86/122011
01/01/2012
31/12/2012
40000
PKR102001
Halaman :
Tanggal :
149/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/54/122012
01/01/2013
31/12/2013
7000
PER/54/122012
01/01/2013
31/12/2013
7000
PER/54/122012
01/01/2013
31/12/2013
7000
PER/54/122012
01/01/2013
31/12/2013
7000
51151
PER/53/122012
01/01/2013
31/12/2013
7000
51156
PER/38/122011
01/01/2012
31/12/2012
7000
0284-5800082 52362
PER/39/122011
01/01/2012
31/12/2012
7000
PKM JENGGOT
BUARAN
51171
PER/38/122011
01/01/2012
31/12/2012
7000
07237
PKM KABUNAN
0284-323307
52363
PER/39/122011
01/01/2012
31/12/2012
7000
10
07238
PKM KALIMAS
0284-582065
52363
PER/39/122011
01/01/2012
31/12/2012
7000
11
07239
PKM KEBANDARAN
-08164887321 52357
PER/39/122011
01/01/2012
31/12/2012
7000
12
07240
PKM KEBONDALEM
0284-324697
52371
PER/39/122011
01/01/2012
31/12/2012
7000
13
07241
PKM KLAREYAN
0284-3277245 52362
PER/39/122011
01/01/2012
31/12/2012
7000
14
7227
PKM KLEGO
PEKALONGAN TIMUR
51171
PER/38/122011
01/01/2012
31/12/2012
7000
15
7228
PKM KRAMATSARI
PEKALONGAN BARAT
51191
PER/38/122011
01/01/2012
31/12/2012
7000
16
04815
JL. JLAMPRANG GG V
51151
PER/38/122011
01/01/2012
31/12/2012
7000
17
7232
51151
PER/53/122012
01/01/2013
31/12/2013
7000
18
07242
PKM LOSARI
0285-4473472 52362
PER/54/122012
01/01/2013
31/12/2013
7000
19
07243
PKM MOJO
0285-4474301 52363
PER/39/122011
01/01/2012
31/12/2012
7000
20
07244
PKM MULYOHARJO
0284-326033
52365
PER/39/122011
01/01/2012
31/12/2012
7000
21
04811
PKM NOYONTAAN
JL DR WAHIDIN NO 79 PEKALONGAN
51152
PER/53/122012
01/01/2013
31/12/2013
7000
22
07245
PKM PADURAKSA
0284-321526
52364
PER/54/122012
01/01/2013
31/12/2013
7000
23
04817
51151
PER/53/122012
01/01/2013
31/12/2013
7000
24
07246
PKM PETARUKAN
0284-3279487 52363
PER/54/122012
01/01/2013
31/12/2013
7000
07224
PKM BANJARDAWA
0284-3277727 52371
07233
PKM BANTARBOLANG
0284-3278581 52361
07234
PKM BANYUMUDAL
0284-583118
52352
07235
PKM BELIK
0284-3285533 52355
04808
PKM BENDAN
7225
PKM DUKUH
07236
PKM JEBED
7226
RI244010
PKR102001
Halaman :
Tanggal :
150/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/39/122011
01/01/2012
31/12/2012
7000
PER/54/122012
01/01/2013
31/12/2013
7000
PER/54/122012
01/01/2013
31/12/2013
7000
PER/39/122011
01/01/2012
31/12/2012
7000
0285-7927556 52363
PER/39/122011
01/01/2012
31/12/2012
7000
51174
PER/38/122011
01/01/2012
31/12/2012
7000
PKM TIRTO
PEKALONGAN BARAT
51192
PER/38/122011
01/01/2012
31/12/2012
7000
7230
PKM TONDANO
PEKALONGAN KOTA
51174
PER/38/122011
01/01/2012
31/12/2012
7000
33
07252
PKM WARUNGPRING
0284-3285266 52353
PER/39/122011
01/01/2012
31/12/2012
7000
34
07253
PKM WATUKUMPUL
-08122677383 52356
PER/39/122011
01/01/2012
31/12/2012
7000
35
05360
51273
PER/52/122012
01/01/2013
31/12/2013
7000
36
06441
51262
PER/27/122012
01/01/2013
31/12/2013
7000
37
05208
51252
PER/47/122012
01/01/2013
31/12/2013
5300
38
05213
-424621
51155
PER/48/122012
01/01/2013
31/12/2013
2900
39
05212
DR BAMBANG PRASETIJO
51151
PER/31/122012
01/01/2013
31/12/2013
1100
40
05211
DR DIDY SUGIHARTO
51252
PER/23/122012
01/01/2013
31/12/2013
1010
41
05209
DR ENDAH WINARTI
JL A YANI NO 10 A BATANG
51252
PER/21/122012
01/01/2013
31/12/2013
2000
42
05927
DR ENDANG ATASWATI B
51151
PER/32/2012
01/01/2013
31/12/2013
700
43
05216
DR ENY INDARTI
51161
PER/39/122012
01/01/2013
31/12/2013
7000
44
05210
DR H MUCHLASIN MKES
51252
PER/22/122012
01/01/2013
31/12/2013
1890
45
05218
DR H SUPRIYONO
52354
PER/43/122012
01/01/2013
31/12/2013
1000
46
05219
52361
PER/37/122011
01/01/2012
31/12/2012
800
47
06825
-085641551188 51154
PER/33/122012
01/01/2013
31/12/2013
1500
48
05587
DR IRMA S WIDYASTUTI
PER/44/122012
01/01/2013
31/12/2013
2000
25
07247
PKM PULOSARI
-081548829668 52354
26
07248
PKM PURWOHARJO
0285-325020
52363
27
07249
PKM RANDUDONGKAL
RANDUDONGKAL
0284-584312
52362
28
07250
PKM ROWOSARI
0285-4473040 52363
29
07251
PKM SARWODADI
30
7231
PKM SOKOREJO
31
7229
32
RI244010
52352
PKR102001
Halaman :
Tanggal :
151/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
49
7224
DR MARSONO
51162
50
05926
DR PARAMITA
51153
51
07003
AMBOKEMBANG NO 39 KEDUNGWUNI
51164
52
06042
51273
53
05333
54
05456
55
07442
56
05925
57
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/35/122012
01/01/2013
31/12/2013
500
DR.PARAMITA SITI S
PER/38/122012
01/01/2013
31/12/2013
400
DR ENY AMBARWATI
PER/40/122012
01/01/2013
31/12/2013
500
PER/24/122012
01/01/2013
31/12/2013
500
51273
PER/25/122012
01/01/2013
31/12/2013
1500
51151
PER/33/122012
01/01/2013
31/12/2013
7000
52364
PER/45/122012
01/01/2013
31/12/2013
1000
51151
PER/37/122012
01/01/2013
31/12/2013
500
05330
DR. MASKURI
52363
PER/42/122012
01/01/2013
31/12/2013
1500
58
05329
51164
PER/30/122012
01/01/2013
31/12/2013
600
59
05928
51252
PER/51/122011
01/01/2012
31/12/2012
200
60
05331
51161
PER/36/122012
01/01/2013
31/12/2013
7000
61
7444
DR. SAPTENDRO
52352
DR. SAPTENDRO
PER/25/122011
01/08/2012
31/12/2012
4000
62
05064
0285-4493268 51252
PER/29/122012
01/01/2013
31/12/2013
7000
63
07443
DRG INNEKE
51274
DRG INNEKE
PER/51/122012
01/01/2013
31/12/2013
12000
64
05200
51252
PER/20/122012
01/01/2013
31/12/2013
1367
65
06155
KLINIK H A DJUNAID
51153
01/01/2013
31/12/2013
7000
66
05929
KLINIK VANILLA
51153
01/01/2013
31/12/2013
7000
67
06163
R. TRI SULISTYARINI
51272
PER/26/122012
01/01/2013
31/12/2013
1000
68
06260
JL. SRIWIJAYA NO 2
0285-437222
51151
PER/61/122011
01/01/2012
31/12/2012
7000
69
05223
RSUD DR M ASHARI
-321614
52352
PER/62/122011
01/01/2012
31/12/2012
7000
70
05221
JL DR SUTOMO NO 42 BATANG
-391033
51151
PER/63/122011
01/01/2012
31/12/2012
7000
71
06439
51152
PER/64/122011
01/01/2012
31/12/2012
7000
72
06360
51252
PER/65/122011
01/01/2012
31/12/2012
1000
73
06898
0284-321251
52352
PER/66/122011
01/01/2012
31/12/2012
RI244010
DR. HP WINATA R
v
v
v
7000
PKR102001
Halaman :
Tanggal :
152/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
74
07325
0284-321251
52352
75
05224
-421420
51151
76
06722
APOTEK ARAFAH
52352
77
06467
51272
78
05185
OPTIK BIPOLA
0285-422436
51155
79
05227
-422421
51111
80
05226
-423663
81
05184
OPTIK RATU
82
05459
OPTIK RIZKI
RI244010
HARI BUKA
PPK II
S
RS
APT
v
v
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/67/122011
01/01/2012
31/12/2012
7000
PER/68/122011
01/01/2012
31/12/2012
7000
PER/69/122011
01/01/2012
31/12/2012
7000
PER/70/122011
01/01/2012
31/12/2012
7000
PER/64/122012
01/01/2013
31/12/2013
7000
PER/65/122012
01/01/2013
31/12/2013
7000
51152
PER/66/122012
01/01/2013
31/12/2013
7000
0285-424186
51151
PER/63/122012
01/01/2013
31/12/2013
7000
51261
PER/67/122012
01/01/2013
31/12/2013
7000
DR. MASKURI
PKR102001
Halaman :
Tanggal :
153/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
03651
JL DR SOETOMO NO 42 BLORA
0296-531118
58252
02965-531504
10000
03656
0291-593286
59451
0291-591145
7000
03657
0295-381102
59152
0295-381684
7000
06461
BP HAJI DJALAL
0291-434680
59381
05891
BP HUMANICA
0291-446230
59381
01504
JL LUKMONOHADI NO 10 KUDUS
-0291440642
59372
0813
BP MASYITOH
59319
05841
DR ASTUTI JATININGSIH
-08122898046 58371
01503
DR B NANIK MARIANI
10
05893
DR BAMBANG KISMANU
11
05842
DR BUDI YUWONO
12
06636
13
PER/31/012013
01/01/2013
31/12/2013
7000
PER/22/012013
01/01/2013
31/12/2013
7000
PER/13/012013
01/01/2013
31/12/2013
7000
PER/52/112012
01/11/2012
30/11/2012
PER/17/012013
01/01/2013
31/12/2013
7000
-08122565477 59153
PER/01/012013
01/01/2013
31/12/2013
7000
-0811233907
59381
PER/24/012013
01/01/2013
31/12/2013
7000
58167
PER/30/012013
01/01/2013
31/12/2013
7000
DR EKO YULIYANTO
-08164246709 59185
PER/09/012013
01/01/2013
31/12/2013
7000
06498
DR ESTI NURSOFIATI
-081390307235 59271
PER/28/012013
01/01/2013
31/12/2013
70000
14
01502
DR FADILLAH ROSYAD H
-08122935656 59381
PER/04/012013
01/01/2013
31/12/2013
7000
15
05684
DR FAUZIAH LUBIS
-08122550175 59462
PER/05/012013
01/01/2013
31/12/2013
7000
16
01493
DR GUNAWAN DJOJOHADIPUTRO
JL NUSANTARA NO 11 BLORA
0296-531075
58252
PER/15/012013
01/01/2013
31/12/2013
7000
17
01501
DR H BUDI SANTOSO
0291-436666
59381
PER/02/012013
01/01/2013
31/12/2013
7000
18
05895
DR HENDRATNI DEWANTI
59381
PER/26/012013
01/01/2013
31/12/2013
7000
19
03661
DR HERU SETIONO
58254
PER/07/012013
01/01/2013
31/12/2013
7000
20
05233
DR HM FAKHRUDDIN
-085727180092 59461
PER/14/012013
01/01/2013
31/12/2013
7000
21
05892
0291-4250900 59381
PER/23/012013
01/01/2013
31/12/2013
7000
22
01498
DR LAKSMI IWANDARI
-08122837387 59261
PER/08/012013
01/01/2013
31/12/2013
7000
23
01497
DR MUTHIAH ZUFRON
0291-442834
59353
PER/12/012013
01/01/2013
31/12/2013
7000
24
05686
DR PUJI BASUKI
-081329232610 58371
PER/18/012013
01/01/2013
31/12/2013
7500
PER/06/012013
01/01/2013
31/12/2013
7000
RI244010
v
NAJIB
BP MASYITOH
7000
PKR102001
Halaman :
Tanggal :
154/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
25
01495
0291-592610
26
06791
DR SICHAH
-081225254865 59185
27
03815
0291-3308325 59381
28
05126
DR SRI HARTANTO
0296-819014
29
01494
DR SUPRIYADI
30
0814
31
05981
32
HARI BUKA
PPK II
S
RS
APT
59453
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
KAMIS, JUM'AT,
SABTU
PER/29/012013
01/01/2013
31/12/2013
7000
PER/01/012013
01/01/2013
31/12/2013
7000
58261
PER/19/012013
01/01/2013
31/12/2013
7000
59171
PER/11/012013
01/01/2013
31/12/2013
7000
081-56560414 59153
PER/53/112012
01/11/2012
30/11/2013
5000
DR WIDODO SARONO
-08563069493 62382
PER/27/012013
01/01/2013
31/12/2013
7000
05894
59381
PER/25/012013
01/01/2013
31/12/2013
7000
33
06273
DR ZAKARIYA HS
0291-754189
59463
PER/32/012013
01/01/2013
31/12/2013
7000
34
05890
DR ZULISTIANUR
59372
PER/21/012013
01/01/2013
31/12/2013
7000
35
01499
-08122932388 59372
PER/03/012013
01/01/2013
31/12/2013
7000
36
07301
0291-3322017 59381
PER/20/012013
01/01/2013
31/12/2013
7000
37
06497
16457
PER/17/012013
01/01/2013
31/12/2013
30000
38
03655
0291-434008
59372
0291-434008
7000
39
03653
0291-444001
59372
0291-438195
7000
40
03652
7000
41
03650
7000
42
03648
20000
43
03649
10000
44
04102
7000
45
03177
PUSKESMAS TERDEKAT
10000
46
03817
PUSKESMAS TERDEKAT
10000
47
04099
PUSKESMAS TERDEKAT
10000
48
04100
7000
49
03654
RS KARTIKA HUSADA
0291-432532
59381
7000
50
03660
RSU CEPU
0296-421026
58252
0296-424373
7000
51
03659
JL DR SOETOMO NO 42 BLORA
0296-531839
58252
0296-531504
7000
RI244010
DR SICHAH
DR ZULISTIANUR
PKR102001
Halaman :
Tanggal :
155/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
52
03658
0295-691444
53
01512
RS KARTIKA HUSADA
-0291-432532 16414
54
03932
0295-382684
55
01509
RSU CEPU
56
01510
57
01511
58
59252
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
7000
0295-692613
-
PER/42/012012
01/01/2012
31/12/2012
7000
59158
0295-382684
PER/39/012012
01/01/2012
31/12/2012
7000
-0296421026
58252
PER/45/012012
01/01/2012
31/12/2012
7000
JL DR SOETOMO NO 42 BLORA
-0296531118
58371
PER/38/012012
01/01/2012
31/12/2012
7000
-0295-691444 59261
PER/43/012012
01/01/2012
31/12/2012
7000
01507
-0291591175
59452
PER/47/012012
01/01/2012
31/12/2012
7000
59
01508
-0295381102
59154
PER/37/012012
01/01/2012
31/12/2012
7000
60
01506
0291-4440001 59381
PER/34/012012
01/01/2012
31/12/2012
7000
61
04103
RS ISLAM PATI
0295-5517683 59161
0295-452316
PER/35/012012
01/01/2012
31/12/2012
7000
62
05238
0291-434008
59381
0291-434008
PER/36/012012
01/01/2012
31/12/2012
7000
63
05896
0291-434707
59381
0291-434711
PER/33/012012
01/01/2012
31/12/2012
20000
64
07806
RSU AISYIYAH
JL.HOS.COKROAMINOTO NO.248
0291-437780
59372
0291-437780
PER/50/012012
01/01/2012
31/12/2012
15000
65
04098
0295-4191992 59156
0295-4191994
PER/46/012012
01/01/2012
31/12/2012
7000
66
07805
JL.LUKMONOHADI KUDUS
59372
PER/51/012012
01/01/2012
31/12/2012
30000
67
05249
-0291431550
59372
PER/34/012011
01/01/2011
31/12/2011
7000
68
05206
-0291439456
59381
PER/40/012012
01/01/2012
31/12/2012
7000
69
05244
-0291439456
7000
70
05241
JL PEMUDA NO 47 KUDUS
-0291439456
7000
71
05248
JL DR SUSANTO NO 2 PATI
-0291439456
7000
72
05243
-0291439456
7000
73
05247
JL VETERAN NO 14 JEPARA
-0291439456
7000
74
05246
-0291439456
7000
75
05245
JL DR WAHIDIN NO 44 REMBANG
-0291439456
7000
76
05242
JL PEMUDA NO 20 BLORA
-0291439456
7000
RI244010
YAYASAN KRISTEN
KESEJAHTERAAN MARDI
RAHAYU
PKR102001
Halaman :
Tanggal :
156/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/35/042012
01/04/2012
31/03/2013
7000
PER/28/042012
01/04/2012
31/03/2013
7000
PER/33/042012
01/04/2012
31/03/2013
3000
PER/25/042012
01/04/2012
31/03/2013
7000
56252
PER/26/042012
01/04/2012
31/03/2013
7000
56162
PER/34/2012
01/04/2012
31/03/2013
3000
54152
PER/21/042012
01/04/2012
31/03/2013
7000
DR BUDI SETIAWAN
54152
PER/22/042012
01/04/2012
31/03/2013
7000
04877
DR DONY PRIHARTANTO
54152
PER/23/042012
01/04/2012
31/03/2013
7000
10
01535
JL DR SOETOMO NO 67 TEMANGGUNG
56252
PER/24/042012
01/04/2012
31/03/2013
7000
11
05205
DR ENDANG RAHMANTI
56172
PER/30/042012
01/04/2012
31/03/2013
7000
12
01526
DR HENDRAWAN SA
JL KAUMAN NO 7 WONOSOBO
56374
PER/20/042012
01/04/2012
31/03/2013
7000
13
07155
0293-782585
56553
PER/16/032012
01/03/2012
28/02/2013
3000
14
01520
DR IKHSAN SYARIF
56152
PER/31/042012
01/04/2012
31/03/2013
7000
15
03163
DR MACHFUDZ
56152
PER/29/042012
01/04/2012
31/03/2013
7000
16
01523
DR SASONGKO
56195
PER/32/042012
01/04/2012
31/03/2013
7000
17
01534
DR WATI
56252
PER/27/042012
01/04/2012
31/03/2013
7000
18
01527
56351
PER/19/042012
01/04/2012
31/03/2013
7000
19
03758
56252
PER/52/072012
01/07/2012
31/12/2012
7000
20
03759
56151
SENIN, SELASA,
KAMIS, JUM'AT
PER/013/012008
02/01/2008
31/12/2008
7000
21
06334
DRG ASROFI
56253
PER/51/072012
01/07/2012
31/12/2012
7000
22
05916
54183
PER/42/052012
01/05/2012
31/12/2012
6000
23
07715
JL A YANI NO. 104 KEL KEDUNGSARI KEC MAGELANG UTARA 081-333081233 56172
PER/44/72012
01/07/2012
30/06/2013
3000
24
06055
PER/43/052012
01/05/2012
31/12/2012
2000
03787
PUSKESMAS GRABAG I
-0293711336
56193
01521
BP JAMSOSTEK
56152
06185
56153
03166
DR ARTIYONO
56252
03167
DR BAMBANG HENDRO
06729
DR BOY RAMURTHI
01533
DR BUDI HANDOYO
01525
56351
RI244010
GIGI (SHIFT 1)
Halaman :
Tanggal :
157/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
25
07041
JL PASAR NO 2 BLABAK
56553
26
07036
0275-324316
54152
27
06471
56351
28
06056
SRI SUTJIATI
0286-321903
56351
29
03788
30
03922
RST DR SOEDJONO
JL RS DR SOEDJONO MAGELANG
-0293-363061 56152
31
01538
RSU TEMANGGUNG
JL DR SOETOMO NO 67 TEMANGGUNG
56252
32
01537
56151
33
01541
RSU WONOSOBO
JL RSU NO 1 WONOSOBO
0286-321091
56351
34
07374
0293-587014
35
06151
0275-321118
36
03923
OPTIK AKUR
JL PEMUDA NO 67 MAGELANG
-0293-363824 56151
37
05915
OPTIK ISMAIL
56152
38
04879
OPTIK JAGO
56151
39
04878
OPTIK KINANTI
54152
40
07037
OPTIK LYRA
0293-327239
41
06053
42
06054
43
44
POLA PEMBIAYAAN
JAM BUKA
NO IKS
PER/41/032012
01/03/2012
28/02/2013
2000
2000
KAMIS, JUM'AT,
SABTU
PER/50/072012
01/07/2012
31/12/2012
PER/14/022012
01/02/2012
31/01/2013
PER/45/072011
01/07/2012
31/12/2012
5000
PER/32/012010
01/01/2010
31/12/2010
7000
PER/38/042012
01/04/2012
31/03/2013
7000
PER/11/012012
01/01/2012
31/12/2012
7000
PER/12/012012
01/01/2012
31/12/2012
7000
0286-323873
PER/06/012012
01/01/2012
31/12/2012
7000
56151
PER/40/052012
01/05/2012
30/04/2013
3000
54152
0275-325652
PER/18/032012
01/03/2012
28/02/2013
7000
PER/04/012012
01/01/2012
31/12/2012
7000
PER/39/082011
01/08/2011
31/07/2012
500
A DARMAWAN
PER/05/032007
01/03/2007
01/03/2008
7000
SUBAGIYO
PER/035/042008
01/04/2008
31/03/2009
7000
56151
FAQIH UTSMAN,SIP
PER/13/012012
01/01/2012
31/12/2012
1000
56151
PER/03/012012
01/01/2012
31/12/2012
3000
54152
PER/043/122008
01/12/2008
30/11/2009
1000
JL DR SOETOMO NO 67 TEMANGGUNG
56252
PER/39/112009
17/11/2009
17/10/2010
JL RUMAH SAKIT NO 1
56351
PER/38/112009
17/11/2009
17/10/2010
RI244010
JUMLAH
TTG
3000
PKR102001
Halaman :
Tanggal :
158/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
01601
PKM BREBES
KABUPATEN BREBES
52252
01563
PKM BUMIAYU
KABUPATEN BREBES
52266
01561
PKM PAGUYANGAN
KABUPATEN BREBES
52262
04881
BP AS SYIFA
JL KH ZAENAL ARIFIN NO 26
0283-323226
52181
04615
BP PERINTIS
-0283358572
52184
05454
JL GAJAH MADA NO 93
52252
06060
DOKTER SANTOSO
52264
06780
DR ARIEF PINUDJO
JL NAKULA NO 57 SLEROK
06416
DR ENDAH PANCAWATI
10
06061
DR H FAISAL AMRI SH
11
06867
12
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/015/012013
01/01/2013
31/12/2013
PER/038/012012
01/01/2012
31/12/2012
7000
PER/028/012010
01/01/2010
31/12/2010
7000
PER/02/012013
01/01/2013
31/12/2013
7000
PER/03/012013
01/01/2013
31/12/2013
7000
DR KHAERUDIN BAKHRI
PER/011/012013
01/01/2013
31/12/2013
7000
DOKTER SANTOSO
PER/012/2013
01/01/2013
31/12/2013
7000
52194
DR ARIEF PINUDJO
PER/036/082010
01/08/2010
31/07/2011
52193
PER/08/012013
01/01/2013
31/12/2013
52264
PER/040/012013
01/01/2013
31/12/2013
7000
DR H UMAR UTOYO
JL RAYA BULAKAMBA NO 69
52264
PER/042/092012
01/09/2012
31/08/2013
3000
01550
DR HAZAIRIN ACHYANI
52252
PER/09/012013
01/01/2013
31/12/2013
7000
13
05559
DR IRMA YURITA
JL PROF M YAMIN NO 24
52271
PER/014/012013
01/01/2013
31/12/2013
7000
14
06358
DR M IRFAN DANI
52462
PER/032/012012
01/01/2013
31/12/2013
15
06868
DR MELIANSYORI
52461
PER/029/122012
01/01/2013
31/12/2013
3000
16
05061
DR MUNIRUL ANAM
52192
PER/025/122012
01/01/2013
31/12/2013
7000
17
06357
DR MUSLIH DAHLAN
JL WERKUDORO NO 150
52463
DR MUSLIH DAHLAN
PER/05/012013
01/01/2013
31/12/2013
7000
18
06779
DR P.MULYONO
JL RAYA MARGADANA
52194
DR PAULUS MULYONO
PER/016/012013
01/01/2013
31/12/2013
19
06781
DR ROSNELINA
JL RAYA MINDAKA-TARUB
52461
DR ROSNALINA
PER/028/122012
01/01/2013
31/12/2013
3000
20
06777
DR SHOKHEKUN
JL RAYA SURADADI NO 77
52451
DR SHOKHEKUN
PER/027/122012
01/01/2013
31/12/2013
3000
21
06775
DR SUHARJO
52193
DR SUHARJO
PER/026/122012
01/01/2013
31/12/2013
3000
22
01549
DR SUMARYATI BIMO B
52183
PER/07/012013
01/01/2013
31/12/2013
7000
23
06359
52464
PER/024/012013
01/01/2013
31/12/2013
24
05960
DR WIWIK SUKIRANTO
52261
PER/013/012013
01/01/2013
31/12/2013
RI244010
DR H FAISAL AMRI SH
DR M IRFAN DANI
7000
v
v
3000
7000
3000
7000
7000
PKR102001
Halaman :
Tanggal :
159/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/04/012012
01/01/2013
31/12/2013
8000
PER/010/2013
01/01/2013
31/12/2013
7000
PER/030/122012
01/01/2013
31/12/2013
10000
PER/031/122012
01/01/2013
31/12/2013
9000
PER/053/082010
01/08/2010
31/07/2011
PER/032/122012
01/01/2013
31/12/2013
7000
01/01/2013
31/12/2013
6000
PER/049/012013
01/01/2013
31/12/2013
3000
PER/050/092011
01/01/2012
31/12/2012
3000
PER/050/092010
01/09/2010
31/08/2011
3000
PER/033/092011
01/09/2011
31/08/2012
70
PER/06/012013
01/01/2013
31/12/2013
7000
PER/022/012012
01/01/2012
31/12/2012
7000
52181
PER/033/082012
01/08/2012
31/07/2013
52255
PER/036/012012
01/01/2012
31/12/2012
JL AHMAD YANI NO 57
52253
PER/031/012012
01/01/2012
31/12/2012
52183
PER/035/072011
01/07/2011
30/06/2012
06361
JL PALA RAYA NO 54
0283-353387
52194
0283-351518
PER/020/012013
01/01/2013
31/12/2013
43
06862
52451
PER/017/092011
01/09/2011
31/12/2012
44
06863
RSIA PALARAYA
52451
PER/039/092012
01/09/2012
31/08/2013
45
03214
-0283-430249 52252
PER/023/012012
01/01/2012
31/12/2012
46
05637
52252
PER/033/012012
01/02/2012
31/12/2012
47
04955
52252
48
05560
JL ABABIL NO 42
52181
49
03991
JL KS TUBUN TEGAL
52181
50
06782
JL DR SUTOMO SLAWI
52461
51
01628
APOTIK KEJAMBON
-0283-351721 52184
25
01546
DR YOHANA JONOSEWOJO
-0283-358080 52181
26
01623
-0283-432174 52266
27
01624
DRG BAMBANG
-0283-358080 52181
28
06778
52462
29
06316
JL KETILANG NO 13 SLAWI
52193
30
06204
JL WERKUDORO NO 69
52182
31
06776
52192
32
06864
KLINIK ANANDA
JL DR CIPTOMANGUNKUSUMO RT 5 RW 1 KALIGANGSA
52193
33
06865
JL DR CIPTOMANGUNKUSUMO RT 5 RW 1 KALIGANGSA
52461
34
06866
RB HATI MULIA
JL RAYA BULAKAMBA NO 69
52262
35
04954
RSU DR SOESELO
JL DR SUTOMO NO 63 SLAWI
52252
36
01626
52181
37
03638
RSUD BREBES
52261
38
07524
RS ADELLA SLAWI
0283-491154
39
07523
40
05558
RS DEDY JAYA
41
06861
42
v
v
v
DR H FAISAL AMRI SH
v
AULIA, SSI,APT
7000
7000
70
PER/029/012012
01/01/2012
31/12/2012
PER/019/012009
01/01/2009
31/12/2009
PER/021/012012
01/01/2012
31/12/2012
PER/028/012012
01/01/2012
31/12/2012
7000
7000
RI244010
PKR102001
Halaman :
Tanggal :
160/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
52
06783
JL GAJAH MADA NO 69
52264
53
05387
52265
54
05636
OPTIK INDONESIA
55
04110
OPTIK NUSANTARA
JL PANGERAN DIPONEGORO
56
03216
57
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
PER/039/012010
01/01/2010
31/12/2010
PER/058/092010
01/09/2010
31/12/2011
PER/018/012013
01/01/2013
31/12/2013
PER/018/012007
01/01/2007
31/12/2007
-0283-351524 52181
PER/019/012013
01/01/2013
31/12/2013
52192
PER/051/092009
01/09/2009
31/08/2010
52211
PER/043/012012
01/01/2012
31/12/2012
JL AHMAD YANI NO 57
52252
PER/025/012012
01/01/2012
31/12/2012
60
52193
PER/041/082012
01/08/2012
31/07/2013
61
05405
52181
PER/01/012013
01/01/2013
31/12/2013
62
52192
PER/046/092010
01/09/2010
31/08/2011
63
52194
PER/046/092010
01/09/2010
31/08/2011
64
52252
PER/012/012012
01/01/2012
31/12/2012
65
JL ABABIL NO 42
52181
PER/030/012012
01/01/2012
31/12/2012
TAUFIK HIDAYAT
52182
OENRIANTO
52181
JL DR SUTOMO NO 63 SLAWI
58
59
RI244010
RS MITRA SIAGA
DR H M NOERSINGGIH, SP THT
DR H FAISAL AMRI, SH
JUMLAH
TTG
v
v
7000
7000
PKR102001
Halaman :
Tanggal :
161/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/39/122012
SENIN, SELASA, RABU, UMUM (SHIFT
KAMIS, JUM'AT,
MALAM,SHIFT SIANG,SHIFT
SABTU, MINGG
PAGI)
01/01/2013
31/12/2013
7000
PER/01/092012
01/09/2012
31/08/2013
7000
PER/03/092012
01/09/2012
31/08/2013
7000
PER/02/092012
01/09/2012
31/08/2013
7000
DR SULISTYANI
PER/15/092012
01/09/2012
31/08/2013
7000
PER/04/092012
01/09/2012
31/08/2013
7000
PER/25/102012
01/10/2012
30/09/2013
7000
DR LILIK WIJAYANTI
PER/05/092012
01/09/2012
31/08/2013
7000
PER/13/092012
01/09/2012
31/08/2013
7000
-08156745796 57412
PER/14/09/2012
01/09/2012
31/08/2013
7000
57352
081329111800
PER/15/052012
01/06/2012
31/05/2013
7000
57451
PER/03/092012
01/09/2012
31/08/2013
26000
07741
0272-551093
57471
PER/02/032012
01/03/2012
28/02/2013
7000
14
07191
57352
PER/03/112012
01/11/2012
31/10/2013
7000
15
05168
57352
PER/02/092012
01/09/2012
31/08/2013
10000
16
07742
57471
PER/03/032012
01/03/2012
28/02/2013
7000
17
01641
H SATIMIN DR
-0272552740
57467
DR H SATIMIN
PER/09/092012
01/09/2012
31/08/2013
7000
18
01639
-0272323522
57452
PER/07/092012
01/09/2012
31/08/2013
7000
19
01644
JUWARDI DR
-0272551040
57452
DR JUWARDI
PER/011/092012
01/09/2012
31/08/2013
7000
20
01645
MULYONO DR
-08122614022 57454
DR MULYONO
PER/14/092012
01/09/2012
31/08/2013
7000
21
01647
-0272551174
57464
PER/11/082012
01/08/2012
31/07/2013
7000
22
01632
SYAMSUDIN PH DR
-0276323333
57374
DR SYAMSUDIN PH
PER/10/092012
01/09/2012
31/08/2013
7000
23
01646
TERLIEN HS DR
-0272322000
57452
DR TERLIEN HS
PER/13/092012
01/09/2012
31/08/2013
7000
24
04672
57352
PER/28/092012
01/09/2012
31/08/2013
07610
0272-321306
57431
01631
-0276321010
57352
DR DANIEL SUDHARMA
01643
DJOKO WINDOYO DR
57455
DR DJOKO WINDOYO
04775
DR ANDI MARKOCO
57451
DR ANDI MARKOCO
05230
DR SULISTYANI
-0276322028
57362
01635
-08122982618 57451
08048
57412
01637
-0276321245
57378
08018
57412
10
08019
11
06162
12
05460
13
DRG. SUSILAWATI
7000
RI244010
PKR102001
Halaman :
Tanggal :
162/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
25
01652
RSU PANDANARANG
JL KANTIL 14 BOYOLALI
-0276321065
57363
26
05235
-0272321041
57451
27
04325
RS CAKRA HUSADA
JL MERBABU NO 7 KLATEN
57451
28
01651
RSI KLATEN
-0272322252
57451
29
06349
0276-322898
57352
0276-3293400
30
04326
57452
31
06809
57412
32
04832
AKSA OPTIK
57451
33
05655
NOER OPTICAL
57352
NURYANI WIDIASTUTI
34
05240
-08156735758 57451
35
05239
OPTIK KURNIA
-0276321872
57352
36
05654
PRANOTO OPTICAL
37
06808
38
39
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
31/08/2013
7000
PER/20/092012
PER/18/092011
01/09/2011
31/08/2012
7000
PER/27/092012
01/09/2012
31/08/2013
7000
PER/09/092010
01/09/2010
31/08/2011
7000
PER/08/052012
01/05/2012
30/04/2013
PER/22/09/2012
01/09/2012
31/08/2013
PER/13/092012
01/09/2012
31/08/2013
PER/29/092009
01/09/2009
31/08/2010
70
PER/04/072012
01/07/2012
30/06/2013
7000
GUNAWAN
PER/2/09-2010
01/09/2010
31/08/2011
7000
TATAN SUTARDI
PER/25/092012
01/09/2012
31/08/2013
7000
57412
PRANOTO H
PER/05/072012
01/07/2012
30/06/2013
7000
57412
PER/14/092012
01/09/2012
31/08/2013
57451
PER/01/092012
01/09/2012
31/08/2013
7000
JL RAYA SOLO-SEMARANG
57362
PER/21/092012
01/09/2012
31/08/2013
7000
40
JL KANTIL 14 BOYOLALI
57352
PER/20/092012
01/09/2012
31/08/2013
7000
41
JL SURADJI TIRTONEGORO
57452
PER/19/092012
01/09/2012
31/08/2013
7000
42
JL RAYA BOYOLALI-SOLO KM 02
57362
PER/19/092010
01/09/2010
31/08/2011
7000
43
0276-322898
57352
0276-3293400
08/JKK/052012
01/05/2012
30/04/2013
RI244010
MUHAMMADIYAH
7000
PKR102001
Halaman :
Tanggal :
163/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
07782
BKMIA KARTINI
0281-633764
53151
07431
PKM BATUR
JL RAYA BATUR
0286-5986267 53456
07432
PKM BAWANG
JL RAYA BAWANG
0286-597009
53453
06506
0281-891434
53352
05320
0282-5291112 53151
MAULUDIN SAG
03235
BP UMP
53182
UMP
07125
BP VIRA MEDIKA
0281-642043
53151
01654
BP YOS SUDARSO
0281-6440963 53152
01665
DR ACHMAD ARIFIN
53151
10
01666
DR AENDAH SUSANTO
11
04523
DR ALI SAID
12
04792
13
JUMLAH
TTG
PER/31//012013
01/01/2013
31/12/2013
5000
PER/057/072011
01/07/2011
30/06/2012
2000
PER/057/072011
01/07/2011
30/06/2012
1500
01/01/2012
31/12/2012
6000
PER/01/012013
01/01/2013
31/12/2013
7000
PER/12/012013
01/01/2013
31/12/2013
7000
PER/21/012013
01/01/2013
31/12/2013
2500
PER/19/012013
01/01/2013
31/12/2013
7000
PER/19/012012
01/01/2012
31/12/2012
7000
0281-7924192 53151
PER/23/012013
01/01/2013
31/12/2013
7000
0281-571539
53151
PER/22/012013
01/01/2013
31/12/2013
7000
DR ANA SUSANTI
53452
PER/07/012013
01/01/2013
31/12/2013
7000
01658
DS KUTASARI PURBALINGGA
081-327136060 53352
PER/14/012013
01/01/2013
31/12/2013
7000
14
01653
DR BAMBANG SUSANTO
0816-692573
53151
PER/02/012012
01/01/2013
31/12/2013
7000
15
04876
DR EDY WIBOWO
KLAMPOK RT 02 RW 07 BANJARNEGARA
08122-722899 53452
PER/18/012013
01/01/2013
31/12/2013
2500
16
06213
DR ESTI HARYATI
081-22678099 53196
DR ESTI HARYATI
PER/25/012013
01/01/2013
31/12/2013
7000
17
08176
DR HERNI SETIYOWATI
53314
DR HERNI SETIYOWATI
PER/33/012013
01/01/2013
31/12/2013
2000
18
01659
DR NONOT MULYONO
0281-893361
53352
PER/08/012013
01/01/2013
31/12/2013
7000
19
03561
DR NOVITA SABDJAN
0281-641973
53151
PER/03/012013
01/01/2013
31/12/2013
7000
20
03234
DR RUDI KRISTIYANTO
08522-7269999 53151
PER/04/012013
01/01/2013
31/12/2013
7000
21
04793
DR SLAMET SUPRIHADI
-081548843123 53151
PER/16/012013
01/01/2013
31/12/2013
7000
22
07781
-08121559474 53151
PER/30/012013
01/01/2013
31/12/2013
2500
23
08175
DR TITIK KUSUMAWINAKHYU
53193
DR TITIK KUSUMAWINAKHYU
PER/32/012013
01/01/2013
31/12/2013
2500
24
07153
JL SATRIA NO 6 BANYUMAS
0813-25456555 53151
PER/05/012013
01/01/2013
31/12/2013
RI244010
DR ANA SUSANTI
SLAMET SUPRIHADI
3000
PKR102001
Halaman :
Tanggal :
164/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
25
04794
DR WIDIYATI POESOKO
0813-28707155 53352
26
04394
DR YOSO MULYADI
0813-27446757 53352
27
04772
53161
28
04771
53151
29
06141
KLINIK AMANDA
JL MARTADIREJA II NO 32 PURWOKERTO
53151
30
04522
KLINIK ANUGRAH
-NULL
53162
31
04396
32
01668
PMI PURBALINGGA
33
04397
RB BUNDA ARIF
34
07126
35
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/17/012013
01/01/2013
31/12/2013
PER/26/012013
01/01/2013
31/12/2013
PER/10/012013
01/01/2013
31/12/2013
11000
PER/15/012013
01/01/2013
31/12/2013
12000
PER/20/012013
01/01/2013
31/12/2013
7000
PER/06/012013
01/01/2013
31/12/2013
7000
53151
PER/13/012013
01/01/2013
31/12/2013
7000
0281-891359
53352
PER/11/012013
01/01/2013
31/12/2013
7000
JL JATIWINANGUN NO 16 PURWOKERTO
53151
SRI WAHYUNI
PER/24/012013
01/01/2013
31/12/2013
7000
RB LIMAS AGUNG
0281-633431
53152
DR ENDANG A
PER/29/012013
01/01/2013
31/12/2013
5000
06926
RB MITRA IBU
JL SMP 5 NO 4 PURWOKERTO
0281-625083
53151
PER/46/012012
01/01/2012
31/12/2012
7000
36
06507
RB UMMU HANI
JL MAYJEND PANJAITAN NO 40
53352
PER/27/012013
01/01/2013
31/12/2013
10000
37
05053
08122-951046 53151
PER/09/012013
01/01/2013
31/12/2013
38
99988
CABANG SETEMPAT
39
01675
RS DKT
53151
40
01673
RS WIJAYAKUSUMA
-0281633062
53151
41
01676
RSU BANJARNEGARA
-0286591464
53452
42
01671
JL DR GUMBREG NO 1 PURWOKERTO
0281-632708
53151
43
05400
RSUD AJIBARANG
0281-6570004 53151
44
01670
RSUD BANYUMAS
-0281796181
45
06927
JL TENTARA PELAJAR NO 22
46
07128
RSI BANJARNEGARA
47
07127
48
YUVANA DEWANTI DR
DR IDANA ULINNAJAH
v
v
4000
7000
30000
7000
PER/29/012012
01/01/2012
31/12/2012
7000
PER/40/012013
01/01/2013
31/12/2013
7000
PER/28/012012
01/01/2012
31/12/2012
7000
0281-6570005
PER/41/012013
01/01/2013
31/12/2013
7000
53151
PER/26/012012
01/01/2012
31/12/2013
7000
0281-896645
53371
0281-893279
PER/44/012013
01/01/2013
31/12/2013
15000
0286-597034
53471
0286-597015
PER/45/012013
01/01/2013
31/12/2013
7000
RSU BUNDA
0281-635424
53163
0281-632514
YAYASAN BUNDA
PER/47/012013
01/01/2013
31/12/2013
2000
01677
-0281892222
53352
PER/39/012013
01/01/2013
31/12/2013
7000
49
06510
JL LETNAN YUSUP
0281-892844
53371
0281-892844
PER/43/012013
01/01/2013
31/12/2013
5000
50
04623
RS AN NI'MAH
-NULL
PER/33/012012
01/01/2012
31/12/2012
7000
51
01678
0281-7607846 53151
PER/38/012013
01/01/2013
31/12/2013
7000
RI244010
v
v
PKR102001
Halaman :
Tanggal :
165/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
52
04972
53151
53
05250
OPTIK BARU
53151
54
05251
OPTIK HADI
53151
55
06508
JL MASJID 29 PURWOKERTO
0281-7617075 53165
HARTOPO
56
06509
LABORATORIUM AMANDA
JL MARTADIREJA II NO 32 PURWOKERTO
53152
DR YUVANA DEWANTI
57
0281-6844166 53151
RI244010
0281-6844188
HARI BUKA
PPK II
S
RS
APT
NO IKS
JUMLAH
TTG
PER/42/012013
01/01/2013
31/12/2013
7000
PER/36/012013
01/01/2013
31/12/2013
3000
PER/37/012013
01/01/2013
31/12/2013
4000
PER/46/012013
01/01/2013
31/12/2013
PER/34/012013
01/01/2013
31/12/2013
PER/057/092012
01/09/2012
31/08/2013
v
SUGENG
POLA PEMBIAYAAN
JAM BUKA
15000
250000
PKR102001
Halaman :
Tanggal :
166/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/13/012013
01/01/2013
31/12/2013
7000
PER/12/012013
01/01/2013
31/12/2013
7000
PER/11/012013
01/01/2013
31/12/2013
7000
PER/14/012013
01/01/2013
31/12/2013
7000
PER/16/012013
01/01/2013
31/12/2013
14000
PER/04/012013
01/01/2013
31/12/2013
7000
04031
BP ANGELA NUGRAHA
-0246922140
50661
01705
BP COCA COLA
-0298523333
50661
01689
-024-6922430 50661
04681
BP PRIMADENTA
024-76912672 50511
DR HERIYANTO
07133
BP TRI KARYA
50511
LILIS WIJAYANTI
01706
DR A FERIKA INDRIANTO
-0298591331
50661
07331
DR AAM AMALIA
50511
07603
DR CHOIRUL ANAM
0817-79546050 50651
01680
DR IMAM PURWADI
-0298324130
50661
10
07863
0298-594532
50612
11
07159
DR NUGRAHA
50511
12
01703
DR RINI SUSILOWATI
-024-6930615 50661
13
05368
DR T YENNY TEDJOSUKMONO
JL LANGENSUKO NO 31 SALATIGA
0298-
14
05398
15
01679
DR TRI WAHYUNININGSIH
16
04032
17
DR AAM AMALIA
PER/10/012013
01/01/2013
31/12/2013
5000
DR CHOIRUL ANAM
PER/05/012013
01/01/2013
31/12/2013
5000
PER/02/012013
01/01/2013
31/12/2013
8500
PER/09/012013
01/01/2013
31/12/2013
1500
DR NUGRAHA
PER/08/012012
01/01/2013
31/12/2013
5000
PER/03/012013
01/01/2013
31/12/2013
7000
50552
0298-
PER/15/012013
01/01/2013
31/12/2013
4000
50511
PER/19/012013
01/01/2013
31/12/2013
7000
-0811273608
50661
PER/01/012013
01/01/2013
31/12/2013
15000
50661
PER/23/012013
01/01/2013
31/12/2013
20000
06803
DRG DARYANTO
50712
DRG DARYANTO
PER/22/012013
01/01/2013
31/12/2013
5000
18
07942
50511
PER/42/062012
01/07/2012
31/12/2012
19
04033
JL DR CIPTO NO 12 AMBARAWA
50511
PER/20/012013
01/01/2013
31/12/2013
20
06665
0811-929834
50141
PER/21/012012
01/01/2012
31/12/2012
21
03903
50661
PER/17/012013
01/01/2013
31/12/2013
15000
22
03905
HARYONO X DRG
JL ADISUCIPTO 25 SALATIGA
50661
PER/18/012013
01/01/2013
31/12/2013
9000
23
06154
KLINIK DR BUDHI
50552
PER/06/012013
01/01/2013
31/12/2013
6000
24
05258
KLINIK PROMEDIKA
-0246923335
50661
PER/07/012013
01/01/2013
31/12/2013
7000
25
01727
RSUD AMBARAWA
-0298591020
50661
-0298591866
PER/24/012012
01/01/2012
31/12/2012
7000
26
01728
RSUD SALATIGA
JL OSAMALIKI NO 19 SALATIGA
-0298324074
50511
-0298321925
PER/65/092012
01/10/2012
31/12/2013
7000
RI244010
1550
7000
v
v
7000
PKR102001
Halaman :
Tanggal :
167/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
27
01726
RSUD UNGARAN
-024-6921006 50661
28
06821
RS BINA KASIH
0298-591280
50141
DR H MUNDJIRIN ES
29
07134
APOTIK HUSADA
50712
TRI HARTATI
30
04034
APOTIK KARTINI
JL KARTINI NO 30 AMBARAWA
0298-596286
50511
31
06147
OPTIK D-D
0298-327876
50772
32
06598
OPTIK GAGAS
50141
33
05259
OPTIK INTAN
-0246922617
34
07864
OPTIK MEGA
35
06631
OPTIK PRANOTO
RI244010
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/23/012012
01/01/2012
31/12/2012
PER/44/092011
01/09/2011
31/12/2012
PER/28/012012
01/01/2012
31/12/2012
PER/27/012012
01/01/2012
31/12/2012
7000
PER/30/012012
01/01/2012
31/12/2012
7000
PER/31/012012
01/01/2012
31/12/2012
7000
50511
PER/31/012013
01/01/2013
31/12/2013
7000
0298-7186653 50511
PER/40/042012
01/05/2012
31/12/2012
200
0298-311177
50141
PER/32/012012
01/01/2012
31/12/2012
4000
PKR102001
Halaman :
Tanggal :
168/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
-0291685018
02638
07665
92635
BP NAYAKA HUSADA IV
024-70197060 59552
02623
BP NAYAKA HUSADA V
024-3522869
59552
02622
50141
02620
02630
02634
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/08/2013
01/01/2013
31/12/2013
PER/11/012013
01/01/2013
31/12/2013
7000
PER/12/012013
01/01/2013
31/12/2013
7000
PER/03/012013
01/01/2013
31/12/2013
7000
PER/02/012013
01/01/2013
31/12/2013
7000
-081575609260 59563
DR H FUAD ALHAMIDY
PER/01/012013
01/01/2013
31/12/2013
7000
-081565892750 50661
DR HM AGUS S
PER/04/012013
01/01/2013
31/12/2013
7000
DR HJ DYAH R S
PER/22/012013
01/01/2013
31/12/2013
7000
06679
024-70760097 59563
DR HJ DYAH RAMMANI
SOFIAWATI
PER/25/012013
01/01/2013
31/12/2013
7000
10
02631
50661
DR KUSMIYATI TJAHYONO
PER/21/012013
01/01/2013
31/12/2013
7000
11
03719
024-3551597
50661
PER/23/012013
01/01/2013
31/12/2013
7000
12
04805
DR RATNASTUTI MASITOH
024-86455799 50661
DR RATNASTUTI MASITOH
PER/24/012013
01/01/2013
31/12/2013
7000
13
07663
DR ROSE INDAH
PER/26/012013
01/01/2013
31/12/2013
7000
14
02632
DR SRIYATI
-081390317740 50663
DR SRIYATI
PER/05/012013
01/01/2013
31/12/2013
7000
15
07664
024-70191667 50167
HJ ANISFA BAKAR
PER/27/012013
01/01/2013
31/12/2013
7000
16
06368
024-70693699 50771
PER/09/012013
01/01/2013
31/12/2013
15000
17
07019
-08164254331 59563
PER/10/012013
01/01/2013
31/12/2013
15000
18
02636
-08122903087 50661
PER/06/012013
01/01/2013
31/12/2013
15000
19
02637
-081325061822 50661
PER/07/012012
01/01/2013
31/12/2013
25000
20
02640
-0291685018
59552
PER/13/012013
01/01/2013
31/12/2013
21
02639
024-6580019
50112
024-6581928
PER/14/012013
01/01/2013
31/12/2013
7000
22
04081
INTERNATIONAL OPTIK
024-8412309
50662
024-
ANDIK SUPONO
PER/16/012013
01/01/2013
31/12/2013
7000
23
04080
LIA OPTIK
024-3564089
50664
ACHMAD YANI
PER/17/012013
01/01/2013
31/12/2013
24
04082
MONALISA OPTIK
024-6712129
50662
PATRICIA ANGELA
PER/18/012013
01/01/2013
31/12/2013
25
04298
PANDANARAN OPTIK
JL PANDANARAN NO 31 SEMARANG
024-8313203
50663
TAUFIQ CHOLIL
PER/19/012013
01/01/2013
31/12/2013
59552
RI244010
PKR102001
Halaman :
Tanggal :
169/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
26
04079
27
RI244010
SA ISMAIL OPTIK
024-3565825
50662
024-6580019
50112
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/20/012013
01/01/2013
31/12/2013
PER/15/012013
01/01/2013
31/12/2013
7000
7000
PKR102001
Halaman :
Tanggal :
170/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/15/012013
01/01/2013
31/12/2013
7000
PER/08/012013
01/01/2013
31/12/2013
7000
PER/09/012013
01/01/2013
31/12/2013
8000
PER/07/012013
01/01/2013
31/12/2013
7000
SITI MURIYAH
PER/06/012013
01/01/2013
31/12/2013
7000
PER/05/012013
01/01/2013
31/12/2013
7000
60265
CV INTI PRATAMA
PER/11/012013
01/01/2013
31/12/2013
7000
031-71231035 60282
PER/02/012013
01/01/2013
31/12/2013
7000
BP. JAMSOSTEK 36
031-5045886
60284
CV. SARTIKA
PER/03/012013
01/01/2013
31/12/2013
6000
02066
BP. JAMSOSTEK 65
031-
60282
PER/04/012013
01/01/2013
31/12/2013
10000
11
02033
031-70295126 60246
PER/10/012013
01/01/2013
31/12/2013
7000
12
06748
031-5040990
60245
031-5019737
DR HERU PURWANTO
PER/14/012013
01/01/2013
31/12/2013
5000
13
05649
031-5345106
60272
PER/12/012013
01/01/2013
31/12/2013
7000
14
06169
031-7524408
60228
031-7530816
PER/13/012013
01/01/2013
31/12/2013
7000
15
02057
KLINIK NAYAKA 05
031-5624649
60263
PER/01/012013
01/01/2013
31/12/2013
8000
16
05650
031-5019898
60282
031-5024591
PER/32/072009
01/07/2009
30/06/2010
7000
17
03543
RS BHAYANGKARA HS SAMSOERI M
031-8292227
60122
031-8299502
POLDA JATIM
PER/17/012012
01/01/2012
31/12/2012
7000
18
07591
RS TK III BRAWIJAYA
JL KESATRIAN 17
031-5682088
60241
031-5611272
KODAM V BRAWIJAYA
PER/19/012012
01/01/2012
31/12/2012
7000
19
02035
031-5501742
60185
RSUD DR SOETOMO
PER/16/012012
01/01/2012
31/12/2012
7000
20
05651
031-5019898
60282
031-5024591
PER/18/012012
01/01/2012
31/12/2012
21
03546
-031-3537107 60161
22
03544
JL KERTAJAYA 33 SURABAYA
031-5035824
60115
23
06566
OPTIK BERLIAN
031-7411518
60186
24
03545
25
04637
60265
26
04639
60112
27
03547
031-5033946
60284
06942
JL INDRAKILA NO 2A
031-5013610
60131
02869
BP JAMSOSTEK 102
031-78071401 60172
02871
BP JAMSOSTEK 104
-031-5322566 60254
02817
BP JAMSOSTEK 79
JL SIMOREJOSARI B NO 54 SURABAYA
-031-7482507 60181
SITI MURIYAH
02819
BP JAMSOSTEK 84
60181
02874
-0318287131
60234
02060
-0315677767
02030
BP. JAMSOSTEK 14
02064
10
RI244010
v
v
v
v
7000
TITI KARTINI S
PER/20/01212
01/01/2012
31/12/2012
7000
SYLVIE ANGELINA
PER/21/012012
01/01/2012
31/12/2012
7000
7000
EDY WIYONO
PER/25/012012
01/01/2012
31/12/2012
PER/22/012012
01/01/2012
31/12/2012
7000
PKR102001
Halaman :
Tanggal :
171/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
28
03548
LAB POPULER
-031-7413485 60185
29
04635
031-8437902
30
06244
JL NIAS 26 SURABAYA
31
02070
32
HARI BUKA
PPK II
S
RS
APT
31/12/2012
7000
PER/26/012012
01/01/2012
31/12/2012
7000
PER/24/012012
01/01/2012
31/12/2012
7000
PER/24/042010
01/04/2010
31/03/2011
60244
031-8414840
TEGUH SETYAWANTO
031-5032055
60282
031-5038068
60132
04638
33
04636
34
031-8292227
RI244010
POLDA JATIM
01/01/2012
CV POPULER
031-8298502
NO IKS
JUMLAH
TTG
PER/23/012012
60122
POLA PEMBIAYAAN
JAM BUKA
7000
PKR102001
Halaman :
Tanggal :
172/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER / 82 / 122012
01/01/2013
31/12/2013
15000
PER / 82 / 122012
01/01/2013
31/12/2013
7000
PER / 76 / 122012
01/01/2013
31/12/2013
7000
PER / 38 / 082012
01/09/2012
31/12/2013
PER / 47 / 082012
01/09/2012
31/08/2013
7000
PER / 80 / 122012
01/01/2013
31/12/2013
7000
PER / 40 / 082012
01/09/2012
31/08/2013
7000
PER / 77 / 122012
01/01/2013
31/12/2013
7000
PER / 39 / 082012
01/09/2012
31/08/2013
PER / 75 / 122012
01/01/2013
31/12/2013
7000
PER / 90 / 122012
01/01/2013
31/12/2013
7000
SENIN, SELASA,
KAMIS, JUM'AT,
SABTU, MINGGU
UMUM (SHIFT 1)
PER / 91 / 122012
01/01/2013
31/12/2013
7000
PER / 78 / 122012
01/01/2013
31/12/2013
7000
PER / 41 / 082012
01/09/2012
31/12/2013
7000
PER / 46 / 082012
01/09/2012
31/08/2013
7000
64391
PER / 79 / 122012
01/01/2013
31/12/2013
14000
64174
PER / 42 /082012
01/09/2012
31/08/2013
7000
64151
PER / 42 / 082012
01/09/2012
31/08/2013
7000
64183
PER / 43 / 082012
01/09/2012
31/08/2013
7000
08035
64111
PER / 44 / 082012
01/09/2012
31/08/2013
7000
21
06454
0354-476376
63419
PER / 73 / 122012
01/01/2013
31/12/2013
7000
22
06335
0354-779500
64152
PER / 83 / 122012
01/01/2013
31/12/2013
7000
23
07633
0354-546194
64174
DR IRFAN RAHMANTO
PER / 84 / 122012
01/01/2013
31/12/2013
7000
24
07968
0354-683640
64111
0354-696793
PER / 92 / 122012
01/01/2013
31/12/2013
7000
25
07632
0354-7660694 64174
PER / 85 / 122012
01/01/2013
31/12/2013
7000
01751
BP MITRA HUSADA I
-0354-398761 62471
IR.H.TEUKU ISMAIL
01735
-08179625532 64391
IR.H.TEUKU ISMAIL
07743
DR ADIP KUSWORO
-085648111117 64174
DR ADIP KUSWORO
06847
DR AHMAD AFFANDI
64172
08037
DR AMALIA
64151
05008
DR EDI PURWANTO
64391
07492
DR ERNANTI WULANDARI
64174
04782
DR HENRY MULYONO
64151
08034
DR IMRO'ATUS SOLIKAH
64111
10
05007
DR NUPRIYANTO
64451
11
07430
DR RAHMAD SANTOSA
64174
12
07362
PEREMPATAN DS JONGBIRU
64174
13
04353
64482
14
06846
64172
15
08036
64151
16
06455
17
06826
DRG RESNAWATI
18
06872
DRG RESNAWATI
19
06828
20
RI244010
DR EDI PURWANTO
DR NUPRIYANTO
DR SIFERA AMELITA S.
DR KURNIAWAN SANTOSO
7000
7000
PKR102001
Halaman :
Tanggal :
173/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
26
01750
BP DHAHA MEDIKA
-0354-672511
27
01729
BP MITRA HUSADA II
-08123204763
28
01730
BP. MELIA
-0354-681820
29
07189
RS BHAYANGKARA NGANJUK
0358-3218896 64451
30
04783
64151
31
06686
RSUD NGANJUK
DR SOETOMO 62 NGANJUK
64391
32
05010
RSUD NGANJUK
JL DR SOETOMO 62 NGANJUK
64391
33
07187
0354-687466
64151
34
07188
35
07186
36
04311
-0354-391047 64293
37
07634
JL.JOYOBOYO NO.42 ;
0354-671939
38
01743
APOTIK SURYA
39
07190
OPTIK CORNEA
40
07997
41
POLRI
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER / 74 / 122012
01/01/2013
31/12/2013
20000
PER / 82 / 122012
01/01/2013
31/12/2013
7000
PER / 81 / 122012
01/01/2013
31/12/2013
7000
01/01/2012
31/12/2012
7000
PER / 78 / 122011
01/01/2012
31/12/2012
7000
PER / 81 / 122011
01/01/2012
31/12/2012
7000
0354-699928
PER / 88 / 122011
01/01/2012
31/12/2012
7000
64174
SLAMET RIYANTO
PER / 89 / 122011
01/01/2012
31/12/2012
7000
64151
DR SAMSUL ASHAR,SP.PD
PER / 87 / 122011
01/01/2012
31/12/2012
7000
-0354-392883 PTP X
PER / 80 / 012012
01/07/2012
31/12/2012
7000
64174
PER / 82 / 122011
01/01/2012
31/12/2012
0354-682966
64151
PER / 88 / 122012
01/01/2013
31/12/2013
64151
SUTANTO
PER / 68 / 122012
01/01/2013
31/12/2013
7000
0354-699922
64111
NURSALIM
PER / 69 / 122012
01/01/2013
31/12/2013
7000
07425
OPTIK PRIMADONA
64174
YUDI SETIAWAN
PER / 70 / 122012
01/01/2013
31/12/2013
42
07361
OPTIK RAPI
JL.A.YANI NO.15
64391
HADI WIDODO
PER / 71 / 122012
01/01/2013
31/12/2013
43
07635
OPTIK TJIANG
JL.DHOHO 75
0354-683332
64151
PER / 72 / 122012
01/01/2013
31/12/2013
44
64151
POLRI
PER / 87 / 122012
01/01/2013
31/12/2013
45
JL.K.H.WAHID HASYIM NO 64
0354-773097
64151
PER / 86 / 122012
01/01/2013
31/12/2013
RI244010
DR BENI CAHYO
7000
v
v
7000
7000
PKR102001
Halaman :
Tanggal :
174/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
01784
0341-896309
65181
01754
PUSKESMAS DAMPIT
0341-896309
65181
06218
0341-826114
65175
01758
BP / RB. "NUSANTARA"
0341-395553
65163
07152
BP NAYAKA HUSADA 02
0341-477805
65151
0341-402099
01771
0341-362954
65131
06850
0341-477805
65151
01752
DR SRI RAHATI
0341-879098
65393
01767
DR WIDYA DAMAYANTI
65152
10
01781
11
03664
12
01765
13
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/64/102012
01/11/2012
31/12/2013
7000
PER/01/012013
01/01/2013
31/12/2013
7000
PER/43/072012
01/07/2012
30/06/2013
7000
PER/02/012013
01/01/2013
31/12/2013
7000
PER/44/072012
01/07/2012
30/06/2013
14000
PER/62/102012
01/11/2012
31/12/2013
7000
PER/28/072012
01/07/2012
30/06/2013
7000
PER/45/072012
01/07/2012
30/06/2013
7000
0341-7701375 65154
PER/27/072012
01/07/2012
30/06/2013
7000
-081931841868 65156
PER/46/072012
01/07/2012
30/06/2013
7000
65151
PER/41/072012
01/07/2012
30/06/2013
7000
01772
0341-7011590 65132
PER/40/072012
01/07/2012
30/06/2013
7000
14
01764
65149
PER/39/072012
01/07/2012
30/06/2013
7000
15
01775
0341-441328
65153
PER/38/072012
01/07/2012
30/06/2013
7000
16
02611
65391
PER/37/072012
01/07/2012
30/06/2013
7000
17
01762
0341-570047
65144
PER/36/072012
01/07/2012
30/06/2013
7000
18
04937
65151
PER/03/012013
01/01/2013
31/12/2013
7000
19
02613
0341-567167
65155
PER/35/072012
01/07/2012
30/06/2013
7000
20
01763
0341-713397
65139
PER/33/072012
01/07/2012
30/06/2013
7000
21
01755
0341-879098
65174
PER/32/072012
01/07/2012
30/06/2013
7000
22
01756
0341-397739
65163
PER/34/072012
01/07/2012
30/06/2013
7000
23
01759
0341-7025094 65151
PER/29/072012
01/07/2012
30/06/2013
7000
24
01779
65152
PER/04/012013
01/01/2013
31/12/2013
7000
25
04938
-08123243045 65151
PER/05/012013
01/01/2013
31/12/2013
7000
26
01789
0341-491320
65126
PER/26/072012
01/07/2012
30/06/2013
7000
27
01793
0341-563358
65115
PER/06/012013
01/01/2013
31/12/2013
7000
28
06229
PER/07/012013
01/01/2013
31/12/2013
7000
RI244010
DR.SRI JULIATI
PUSPHA RACHMAWATI
PKR102001
Halaman :
Tanggal :
175/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
29
06318
JL.DIPONEGORO NO 93 BATU
65391
30
01776
65153
31
07599
0341-336271
65151
0341-336271
32
07689
0341-494969
65153
33
01780
0341-385257
65165
34
01786
65163
35
01790
0341-493059
65126
36
01770
0341-493059
65156
MUHAMMADIYAH CABANG
BLIMBING
37
07572
JL. SUDIMORO NO 16
0341-406150
65151
YPPI WIDYAGAMA
38
01753
RB."KARYATIN"
0341-823057
65171
39
07389
JL. RA KARTINI NO 1
0341-597023
65391
0341-597023
40
01798
0341-362101
65152
41
03722
RSUD LAWANG
0341-426072
65211
42
07903
RS PERMATA BUNDA
0341-487487
43
08038
RS WAVA HUSADA
44
07730
45
07527
46
DRG.JOSEPHINE NOVITA
WARDHANI
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/63/092012
01/09/2012
31/12/2013
PER/47/072012
01/07/2012
30/06/2013
7000
PER/08/012013
01/01/2013
31/12/2013
7000
PER/09/012013
01/01/2013
31/12/2013
7000
PER/42/072012
01/07/2012
30/06/2013
7000
PER/25/072012
01/07/2012
30/06/2013
7000
PER/10/012013
01/01/2013
31/12/2013
7000
PER/31/072012
01/07/2012
30/06/2013
7000
PER/60/102012
01/10/2012
31/12/2013
7000
PER/30/072012
01/07/2012
30/06/2013
7000
PER/47/052012
01/05/2012
30/04/2013
v
v
PER/15/052012
01/01/2012
31/12/2012
7000
PER/13/012012
01/01/2012
31/12/2012
7000
65151
PER/19/05.2012
01/05/2012
30/04/2013
7000
0341-393000
65163
0341-398398
PER/22/052012
01/06/2012
31/05/2013
0341-594161
65391
0341-598911
PER/05/122011
01/01/2012
31/12/2012
7000
0341-837777
65151
PER/59/102012
01/10/2012
31/12/2013
7000
07731
0341-552955
65151
0341-
PER/06/022012
01/03/2012
31/12/2012
7000
47
05656
0341-480047
65162
PER/53/042012
01/04/2012
31/03/2013
7000
48
07406
0341-341357
65151
0341-365094
PER/55/072012
01/07/2012
30/06/2013
49
07902
0341-426705
65152
PER/16/052012
01/05/2012
31/12/2012
50
07571
0341-460558
65152
PER/65/102012
01/11/2012
31/12/2013
7000
51
05193
0341-551356
65154
0341-577205
PER/03/112011
01/11/2011
31/12/2012
7000
52
06938
0341-458679
65153
0341-441874
DR.SADI HARIONO
PER/04/112011
01/11/2011
31/12/2012
7000
53
03754
APOTIK "BROMO"
0341-341818
65119
PER/01/062010
01/07/2010
30/06/2011
7000
54
03688
65118
PER/01-OPTIC/062010
01/06/2010
31/05/2011
7000
55
03687
INTERKONTINENTAL OPTIC
65158
PER/01-OPTIC/052010
01/06/2010
31/05/2011
7000
56
01800
INTERNATIONAL OPTIC
0341-366306
65158
PER/54/062012
01/06/2012
31/05/2013
7000
PEMPROV JATIM
PRAPTI HARIYANTO
RI244010
PKR102001
Halaman :
Tanggal :
176/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
57
07298
OPTIK FIRSTTOLIA
0341-325369
65179
58
03686
VISTA OPTIC
0341-366306
65158
59
05919
0341-324747
65151
60
07360
JL.TANGKUBAN PERAHU 14
0341-326060
65151
0341-323846
61
0341-597023
65391
62
0341-393000
65163
ABNASAMANHUDI SAUTIKA
HUSADA PT
63
0341-426705
65151
64
0341-460558
65162
65
0341-458919
66
67
68
RI244010
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
31/05/2012
PER/02/052011
PER/24/072012
01/06/2012
31/05/2013
7000
PER/57/072012
01/07/2012
30/06/2013
7000
PER/52/062012
01/06/2012
31/05/2013
7000
PER/04/042011
01/05/2011
30/04/2012
PER/22/052012
01/06/2012
31/05/2013
PER/16/052013
01/05/2012
31/12/2012
SUJIATI, SST,MM.KES
PER/03/012012
01/01/2012
31/12/2012
65153
DR.KRISTIWI HANGGRIYANI
PER/18/012013
01/01/2013
31/12/2013
0341-331100
65153
-327930
PER/19/012013
01/01/2013
31/12/2013
7000
0341-458679
65153
0341-441874
DR.SADI HARIONO
PER/17/012013
01/01/2013
31/12/2013
7000
0341-837777
65162
0341-837444
PER/01/122011
01/01/2012
31/12/2012
OETOJO SARDJITO
PKR102001
Halaman :
Tanggal :
177/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/02/012013
01/01/2013
31/12/2013
7000
PER/002/012013
01/01/2013
31/12/2013
7000
PER/003/012013
01/01/2013
31/12/2013
7000
DINAS KESEHATAN
PER/02/012012
01/01/2012
31/12/2012
5000
PER/16/012012
01/01/2012
31/12/2012
7000
67353
DINAS KESEHATAN
PER/003/012013
01/01/2013
31/12/2013
0332-321023
68272
PER/16/012012
01/01/2012
31/12/2012
68151
PER/002/012013
01/01/2013
31/12/2013
3000
PUSKESMAS TEMPEH
67352
PER/003/012013
01/01/2013
31/12/2013
7000
02650
DR ABDUL MALIK M
-0331-338952 68151
PER/004/012013
01/01/2013
31/12/2013
7000
11
02653
DR KOESWANDONO
JL DIPONEGORO 44 LUMAJANG
67352
PER/005/012013
01/01/2013
31/12/2013
7000
12
02651
JL KACAPIRING 47 JEMBER
-0331-482119 68151
PER/006/012013
01/01/2013
31/12/2013
7000
13
02654
DR SUYANTO
-0331-485803 68151
PER/007/012013
01/01/2013
31/12/2013
7000
14
03604
JL ARGOPURO 28 A LUMAJANG
67353
PER/001/012013
01/01/2013
31/12/2013
7000
15
04274
-0812395235
68251
PER/012/012013
01/01/2013
31/12/2013
7000
16
06738
JL JAYANEGARA NO. 81
0331-429742
68151
PER/011/012013
01/01/2013
31/12/2013
20000
17
04973
0334-887999
67352
0334-890425
PER/008/012013
01/01/2013
31/12/2013
7000
18
06522
JL KH AGUS SALIM NO 20
68151
PER/009/012013
01/01/2013
31/12/2013
7000
19
04680
68253
PER/010/012013
01/01/2013
31/12/2013
7000
20
05114
RS BHAYANGKARA LUMAJANG
JL KYAI ILYAS NO 7
67352
PER/025/012012
01/01/2012
31/12/2012
20000
21
04495
RSD. DR.H.KOESNADI
-0332421974
68252
PER/026/012011
01/01/2012
31/12/2012
20000
22
04496
RSUD DR.SOEBANDI
-0331487441
68151
PER/023/012012
01/01/2012
31/12/2012
20000
23
07996
0331-3017373 68151
0331-332497
M SUPRIYADI ST
PER/034/072012
01/08/2012
31/12/2012
15000
24
06177
RS CITRA HUSADA
JL TERATAI NO 22
0331-486200
68151
ANDRE KARTAWIDJAYA
PER/021/012012
01/01/2012
31/12/2012
10000
25
07767
0334-881791
67352
0334-888844
DR H KOESWANDONO
PER/21/012012
01/01/2012
31/12/2012
25000
26
05497
APOTEK TRISNO
68151
PER/17/012012
01/01/2012
31/12/2012
10000
05027
PKM BANGSALSARI
67352
06451
PUSKESMAS KALISAT
JL M ARIFIN NO 3 KALISAT
0331-593096
68151
03806
PUSKESMAS KLAKAH
67353
07047
PUSKESMAS PASIRIAN
0334-571254
67383
07116
PUSKESMAS PRAJEKAN
68363
05834
PUSKESMAS RANUYOSO
07117
PUSKESMAS SUKOSARI
06046
PUSKESMAS SUMBERSARI
04685
10
RI244010
7000
v
v
7500
PKR102001
Halaman :
Tanggal :
178/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/42/122012
01/12/2012
30/06/2013
7000
PER/18/012012
01/01/2012
31/12/2012
7000
PER/19/012012
01/01/2012
31/12/2012
7000
RUVI WIDIANTO
PER/22/012012
01/01/2012
31/12/2012
PER/20/012012
01/01/2012
31/12/2012
27
08142
0331-489020
68171
28
04564
ISTANA OPTIKAL
0331-421007
68151
EDDY SANTOSO
29
04563
-0331487908
68151
30
07768
OPTIK SUROBOYO
0331-7259258 68151
31
05314
WIJAYA OPTICAL
67352
RI244010
HARI BUKA
PPK II
7000
PKR102001
Halaman :
Tanggal :
179/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/05/012013
01/01/2013
31/12/2013
8000
PER/01/012013
01/01/2013
31/12/2013
7000
PER/01/012013
01/01/2013
31/12/2013
7000
RIDWAN
PER/02/012013
01/01/2013
31/12/2013
8000
ISMAIL
PER/01/012013
01/01/2013
31/12/2013
12000
67252
DR ARIEF FADILLAH
PER/06/012013
01/01/2013
31/12/2013
8000
67162
RIDWAN MASDOEKI
PER/02/012013
01/01/2013
31/12/2013
6000
0335-422143
67252
RIDWAN
PER/02/012013
01/01/2013
31/12/2013
7000
BP. JAMSOSTEK 19
0335-843346
67252
RIDWAN
PER/02/012013
01/01/2013
31/12/2013
7000
01803
BP. JAMSOSTEK 21
0343-633396
67151
SRI WAHYOE
PER/04/012013
01/01/2013
31/12/2013
7000
11
01804
BP. JAMSOSTEK 50
67151
RIDWAN
PER/02/012013
01/01/2013
31/12/2013
7000
12
01805
BP. JAMSOSTEK 51
0343-741460
67153
RIDWAN
PER/02/012013
01/01/2013
31/12/2013
7000
13
01806
BP. JAMSOSTEK 91
0343-655291
67153
ISMAIL
PER/01/012013
01/01/2013
31/12/2013
12000
14
01880
BP. JAMSOSTEK 95
0343-636028
67151
ISMAIL
PER/01/01/2013
01/01/2013
31/12/2013
18000
15
03769
KLINIK CITRA 1
0343-482366
67151
RIDWAN
PER/02/012013
01/01/2013
31/12/2013
10000
16
01813
KLINIK CITRA 3
0343-631366
67151
RIDWAN
PER/02/012013
01/01/2013
31/12/2013
7000
17
01820
KLINIK CITRA 5
0343-745537
67151
RIDWAN
PER/02/012013
01/01/2013
31/12/2013
7000
18
01826
KLINIK CITRA 6
0335-421756
67252
RIDWAN
PER/02/012013
01/01/2013
31/12/2013
7000
19
01830
0335-841144
67252
DR.LIA BASUKI
PER/03/012013
01/01/2013
31/12/2013
7000
20
07627
PER/07/012013
01/01/2013
31/12/2013
6000
21
04160
RB. AISIYAH
-0343-637367
PER/33/012013
01/01/2013
31/12/2013
7000
22
04162
-0343-411437 67151
DR FITRI INDAHYANTI
PER/10/012012
01/01/2012
31/12/2012
7000
23
04163
PUSKESMAS PURWOSARI
-0343-611521 67162
PER/17/012013
01/01/2013
31/12/2013
7000
24
01868
RSUD. BANGIL
0343-744900
67153
PER/13/012013
01/01/2013
31/12/2013
7000
25
01867
0343-421073
67126
DR SUGENG WINARTO
PER/12/012013
01/01/2013
31/12/2013
7000
26
01865
67219
DR BUDI PURWOHADI
PER/15/012013
01/01/2013
31/12/2013
7000
27
01866
67282
DR HARIYADI SANTOSA
PER/16/012013
01/01/2013
31/12/2013
7000
28
04158
0343-741898
67153
SRI PRASETIJANINGSIH
PER/10/012013
01/01/2013
31/12/2013
7000
29
04159
0343-741460
67153
SOEKARDJI
PER/11/012013
01/01/2013
31/12/2013
7000
30
06164
0343-427659
67151
PER/32/012013
01/01/2013
31/12/2013
7000
05680
BP ARRAHMAH
67151
DR M MUSTAFA K
02626
BP JAMSOSTEK 125
0343-881459
67151
ISMAIL
02629
BP JAMSOSTEK 126
0343-658869
67151
ISMAIL
02625
BP JAMSOSTEK 22
0343-611126
67151
03768
BP JAMSOSTEK 82
0343-6640508 67151
05605
07626
01801
01802
10
RI244010
PKR102001
Halaman :
Tanggal :
180/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
31
04826
LABORATORIUM PRIMA
0343-634685
67151
IBU DAMAYANTI
PER/08/012013
01/01/2013
31/12/2013
7000
32
01881
LABORATORIUM SEJAHTERA
JL AHMAD YANI NO 12
0335-425416
67252
H SUTRISNO, AMDK
PER/31/012013
01/01/2013
31/12/2013
7000
33
04490
LABORATORIUM TANJUNG
0343-842624
67156
EKO MEISTYANANTO, SP
PER/09/012013
01/01/2013
31/12/2013
7000
34
07628
0343-612473
67151
RENI WISMIATI
PER/19/012013
01/01/2013
31/12/2013
10000
35
03613
RS MASITOH
JL A YANI 6
0343-741018
67153
DR H HANDAYANTO MM
PER/14/012013
01/01/2013
31/12/2013
7000
36
06208
RS PANCA DHARMA
JL RAYA SUKOREJO NO 14 A
67161
PER/18/012013
01/01/2013
31/12/2013
10000
37
06979
0343-636064
67156
0343-636083
PER/11/012012
01/01/2012
31/12/2012
38
05087
APOTEK SUMBERWARAS
67151
MA MARGONO
39
03618
RSUD BANGIL
40
04369
0343-426342
67151
DRA YULETI MM
41
01869
APOTIK FAJAR
0335-423717
67252
SOEHARJITO, BSC
42
03614
APOTIK PASURUAN
JL BALAIKOTA 33 PASURUAN
0343-421102
67151
ROY DANUSEPUTRO
43
01870
APOTIK PASURUAN
0343-421102
67151
ROY DANUSEPUTRO
PER/18/IKS/012008
01/01/2008
31/12/2008
7000
44
04368
APOTIK PURUT
0343-423691
67151
DRG RUSDIANTO
PER/21/IKS/012009
01/01/2009
31/12/2009
7000
45
01872
APOTIK RACHMAT
0343-424326
67151
H MOCH EDDY
PER/23/IKS/012009
01/01/2009
31/12/2009
7000
46
04157
APOTIK WARAS
JL DR SOETOMO NO 7 BANGIL
0343-741907
67153
PER/21/012013
01/01/2013
31/12/2013
7000
47
01874
APOTIK ALOHA
61274
7000
48
01871
APOTIK ANJASMORO
7000
49
01873
APOTIK BANGIL
7000
50
03615
APOTIK FAJAR
7000
51
01875
JL.
7000
52
01878
OPTIK ARIES
0343-633794
67151
53
06363
OPTIK DUTA
67251
54
03617
0335-422357
55
03616
56
05086
OPTIK JJ
57
04370
58
59
PROBOLINGGO
70
7000
PER/22/012013
01/01/2013
31/12/2013
7000
PER/20/012013
01/01/2013
31/12/2013
7000
7000
PER/28/012013
01/01/2013
31/12/2013
7000
PER/30/012013
01/01/2013
31/12/2013
1000
67252
PER/24/012013
01/01/2013
31/12/2013
7000
0343-427002
67151
PER/23/012013
01/01/2013
31/12/2013
7000
JL RA KARTINI 16 D PANDAAN
0343-635682
67151
MA MARGONO
PER/29/012013
01/01/2013
31/12/2013
OPTIK MARLIN
0343-423212
67151
NORMA LUCAS
PER/25/012013
01/01/2013
31/12/2013
7000
01877
OPTIK SAMUDRA
0343-742171
67153
IRAWAN TANUMIHARDJA
PER/26/012013
01/01/2013
31/12/2013
7000
04371
67282
SURIADI
PER/27/012013
01/01/2013
31/12/2013
7000
RI244010
MUSLIM
PKR102001
Halaman :
Tanggal :
181/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
60
01876
OPTIK INTERNASIONAL
7000
61
01879
OPTIK INTERNASIONAL
7000
62
04489
OPTIK TERANG
-03437743274
7000
63
05563
LABORATORIUM IRMA
JL A I S NASUTION NO 6
67251
SOEHARDJITO, BSC
PER/20/IKS/012009
01/01/2009
31/12/2009
64
04825
LABORATORIUM MEDIS
JL BALAIKOTA NO 33 PASURUAN
0343-424450
67151
0343-425585
ROY DANUSEPUTRO
PER/14/IKS/012009
01/01/2009
31/12/2009
65
01883
7000
66
01882
7000
67
JL A YANI NO 6 BANGIL
67153
DR H. HANDAYANTO
PER/42/IKS/TC/072007
01/01/2008
30/06/2008
68
67251
PER/41/IKS/TC/052008
01/01/2008
31/12/2008
69
67282
PER/40/IKS/TC/052008
01/01/2008
31/12/2008
RI244010
7000
PKR102001
Halaman :
Tanggal :
182/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/21/062012
01/07/2012
30/06/2013
11100
PER/17/062012
01/07/2012
30/06/2013
7000
PER/17/062012
01/07/2012
30/06/2013
7500
PER/31/062012
01/07/2012
30/06/2013
5000
PER/19/062012
01/07/2012
30/06/2013
8000
MUHAMMAD RIDWAN SH
PER/22/062012
01/07/2012
30/06/2013
7000
0321-877187
IR T ISMAIL
PER/17/062012
01/07/2012
30/06/2013
9000
61352
0321-877187
IR T ISMAIL
PER/17/062012
01/07/2012
30/06/2013
7000
61411
PER/42/12-2012
01/01/2013
31/12/2013
5000
0321-6986060 61481
DR HJ NURUL ANSITA
PER/50/012013
01/01/2013
31/12/2013
7000
0321-592649
PER/20/062012
01/07/2012
30/06/2013
11650
07498
0321-6817979 61351
PER/23/062012
01/07/2012
30/06/2013
5000
13
07297
0321-513355
0321-513366
PER/24/062012
01/07/2012
30/06/2013
5000
14
07413
081-330000091 61452
IR H ISMAIL
PER/17/062012
01/07/2012
30/06/2013
7500
15
07641
61372
PER/33/062012
01/07/2012
30/06/2013
7000
16
08068
JL RAYA JABON KM 6
0321-7494000 61364
PER/38/102012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
GIGI (SHIFT 1), SALIN (SHIFT
KAMIS, JUM'AT,
1)
SABTU, MINGG
01/11/2012
30/06/2013
5000
17
07694
PER/32/062012
01/07/2012
30/06/2013
7000
18
04613
POLI MITRA 11
0321-6214181 61473
0321-877187
IR T ISMAIL
PER/17/062012
01/07/2012
30/06/2013
7000
19
03840
POLI MITRA 12
JL ANGGREK NO 24 JOMBANG
0321-878318
61413
0321-877187
IR T ISMAIL
PER/17/062012
01/07/2012
30/06/2013
14000
20
05142
POLI MITRA 26
0321-885122
61453
0321-877187
IR T ISMAIL
PER/17/062012
01/07/2012
30/06/2013
8500
21
03836
0321-594450
61382
PER/15/052012
01/07/2012
30/06/2013
11650
22
05144
RS SUMBER GLAGAH
0321-690441
61374
0321-690137
PER/42/122011
01/12/2011
30/11/2012
23
01895
RSUD JOMBANG
61452
PER/25/062012
01/07/2012
30/06/2013
7000
24
01892
0321-591591
61382
PER/46/122011
01/01/2012
31/12/2012
7000
01/01/2012
30/06/2012
7000
06676
BP CITA MULIA
0321-323302
61363
DR HARYO BASUKI
06010
BP MITRA 38
0321-492876
61351
IR H T ISMAIL
06011
BP MITRA 39
61462
IR H T ISMAIL
07569
BP MITRA BERSAMA
61351
DR SUJATMIKO
06677
BP NABILA HUSADA
0321-690283
61363
DR SUJATMIKO
06348
BP SAFIRA
0321-323239
61382
01890
0321-6817998 61385
01886
BP. JAMSOSTEK 47
0321-363786
08164
0321-495139
10
08047
DR HJ NURUL ANSITA
11
03837
12
RI244010
61382
61371
61351
PKR102001
Halaman :
Tanggal :
183/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
25
05641
RS DHARMA HUSADA
61385
26
07666
RS EMMA
0321-328737
61363
PER/26/062012
01/07/2012
30/06/2013
27
03844
RS EMMA
0321-328737
61363
0321-396747
DR MAGDALENA SITORUS
PER/20/062010
01/06/2010
31/05/2011
7000
28
05145
RS NUR WACHID
0321-870666
61456
DR HENDRI MARZUKI
PER/03/012012
01/01/2012
31/12/2012
7000
29
04799
RS. KARTINI
0321-592261
61351
DR H EDDIE POESPITO
01/01/2012
31/12/2012
30
04614
0321-598621
61363
0321-598624
DR MARIA M HARLIM
PER/27/062012
01/07/2012
31/12/2012
7000
31
05143
RSI SAKINAH
JL RA BASUNI NO 12 SOOKO
0321-326991
61361
0321-329670
PER/11/022012
01/03/2012
31/12/2012
7000
32
04442
RSI. AROFAH
0321-596900
61382
0321-596019
DR SUBANDI AHMADI
01/01/2012
31/12/2012
33
03842
APOTIK SEHAT
0321-591135
61382
PER/34/062012
01/07/2012
30/06/2013
34
01899
OPTIK FAJAR
0321-322155
61351
HENDRO SASONGKO
PER/5/012012
01/01/2012
31/12/2012
7000
35
06006
0321-7284399 61452
0321-887559
DIDIK PURWANTO
PER/28/062012
01/07/2012
30/06/2013
7000
36
05146
OPTIK NUSA
JL PAHLAWAN NO 40 C
0321-327247
61363
NURSALIM
01/05/2012
30/04/2013
7000
37
03841
OPTIK PELANGI
61351
HERI SURYANTO
PER/49/062012
01/07/2012
30/06/2013
7000
38
06007
OPTIK SENTRAL
JL WACHID HASYIM NO 88
0321-868879
61452
MAT SUKRI
PER/40/072011
01/07/2011
31/12/2011
7000
39
04439
LABORATORIUM ALFA
0321-594450
61382
PER/15/052012
01/06/2012
31/12/2012
40
03845
0321-391954
61351
HADI SOFWAN
PER/37/112011
01/11/2011
31/10/2012
41
03847
LAB ALON-ALON
JL DIPONEGORO NO 3 JOMBANG
7000
42
03846
-0321597029
7000
43
0321-591591
61382
44
JL RAYA IJEN NO 67
61363
DR MAGDALENA SITORUS
45
0321-598621
61363
0321-598624
46
0321-596900
61363
47
JL R A BASUNI NO 12
0321-321922
61363
RI244010
PER/02/012012
01/01/2012
31/12/2012
01/01/2012
31/12/2012
PER/10/032012
01/05/2012
30/04/2013
DR HR SETIOHARTONO
PER/817/042012
01/05/2012
30/04/2013
0321-329670
DR SULAIMAN ROSYID
PER/817/042012
01/05/2012
30/04/2013
7000
PKR102001
Halaman :
Tanggal :
184/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/36/112012
01/01/2013
31/12/2013
7500
PER/42/112012
01/01/2013
31/12/2013
7500
PER/46/112012
01/01/2013
31/12/2013
5000
68453
PER/43/112012
01/01/2013
31/12/2013
7000
-08123219960 68362
PER/44/112012
01/01/2013
31/12/2013
8000
-0333423711
68418
PER/35/112012
01/01/2013
31/12/2013
10000
03807
JL ARGOPURO SITUBONDO
-0333671727
68355
PER/47/112012
01/01/2013
31/12/2013
7000
04041
68482
PER/37/112012
01/01/2013
31/12/2013
9000
04029
DR. REZEKIYANTI
-0333424118
38523
PER/38/112012
01/01/2013
31/12/2013
8000
10
04042
-0333846068
68483
PER/39/112012
01/01/2013
31/12/2013
9000
11
07637
JL PENATARAN
081-23468687 68461
PER/52/112012
01/01/2013
31/03/2013
6000
12
05350
0333-845095
68465
PER/32/112012
01/01/2013
31/12/2013
5000
13
04043
-0333421477
68415
PER/40/112012
01/01/2013
31/12/2013
12500
14
04609
-08123219960 68354
PER/45/112012
01/01/2013
31/12/2013
10000
15
05351
0333-898764
68467
PER/33/112012
01/01/2013
31/12/2013
5000
16
07636
JL P DIPONEGORO 20 ROGOJAMPI
0333-631149
68461
PER/34/112012
01/01/2013
01/12/2013
7000
17
04830
68351
18
04052
RSUD BLAMBANGAN
-0333421118
68418
19
07384
JL ANGGREK 68
0333-671028
68356
20
06391
RS AL HUDA
68465
21
07690
RS YASMIN (JPK)
0333-424671
68463
0333-418219
22
04209
-671174
68351
23
04828
RSUD. SITUBONDO
68351
24
04202
LAB DIKES 1
-421254
68416
25
1200000000005 RS YASMIN
68453
06292
68453
06355
DR HJ FAIDA, MMR
68465
07053
DR PITOYO
081-24976140 68352
02602
DR SINDIANA
-0333451198
04608
DR YUNI VEROSITA
04028
RI244010
PEMDA SITUBONDO
PER/77/122012
01/01/2012
31/12/2012
11000
PER/05/012012
01/01/2012
31/12/2012
10000
PER/06/012012
01/01/2012
31/12/2012
10000
PER/01/012012
01/02/2012
31/12/2012
10000
PER/21/072012
01/07/2012
30/09/2012
7000
70
DR. ISMUNARSO
v
v
036/PER/092008
01/07/2008
30/09/2008
PER/26/072012
01/07/2012
30/06/2013
7000
10000
PKR102001
Halaman :
Tanggal :
185/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
05050
63151
07280
0357-631045
63512
04903
PUSKESMAS BALEREJO
0351-383798
05167
05097
DR SAIFUDIN
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/003/012012
01/01/2012
31/12/2012
7000
-08125249788 DR . H. LEKSONO
PER/024/012013
01/01/2013
31/12/2013
63151
PER/006/012012
01/01/2012
31/12/2012
0351-7788113 63252
PER/016/012013
01/01/2013
31/12/2013
0357-511827
63552
PER/037/092009
01/09/2009
31/08/2010
2500
05051
PUSKESMAS GEGER
0351-367158
63171
PER/004/012012
01/01/2012
31/12/2012
7000
04942
PUSKESMAS KARANGJATI
0351-661024
63252
DR YUDONO
PER/013/012012
01/01/2013
31/12/2013
7000
05098
0357-883486
63552
PER/032/012013
01/01/2013
31/12/2013
2500
05099
0357-636060
63552
PER/020/012012
01/01/2012
31/12/2012
2500
10
08122
PUSKESMAS KREBET
KREBET MADIUN
63153
PER/001/082012
01/08/2012
30/07/2013
12000
11
05165
0351-7756744 63283
12
05056
13
05100
14
05101
15
2000
v
v
7000
2500
2500
0351-331048
DR AGUS PRIYAMBODO
PER/014/012013
01/01/2013
31/12/2013
63151
PER/005/012012
01/01/2012
31/12/2012
7000
0357-371030
63552
DR. PRANINGTYASWIDYANING
PER/032/092009
01/09/2009
31/08/2010
2500
63552
DR. SUKAMTO
PER/027/012012
01/01/2012
31/12/2012
1000
05102
PUSKESMAS PACITAN
0357-883894
63552
PER/022/122012
01/01/2013
31/12/2013
2500
16
04941
PUSKESMAS PADAS
63252
PER/012/012013
01/01/2013
31/12/2013
2500
17
05166
0351-7788522 63252
PER/015/012013
01/01/2013
31/12/2013
2500
18
05103
63552
PER/026/012012
01/01/2012
31/12/2012
2500
19
04779
PUSKESMAS PULUNG
0352-571118
63451
PER/014/012009
01/01/2009
31/12/2009
7000
20
04831
PUSKESMAS SARADAN
0351-383509
63151
DR. PORWASIS
PER/009/012012
01/01/2012
31/12/2012
7000
21
01920
0357-881377
63552
KUSNADI SURAHMAT
PER/021/012012
01/01/2013
31/12/2013
22
05105
0357-5100868 63552
PER/45/092008
01/09/2008
31/08/2009
500
23
07262
0357-441165
63512
DR NATSIR NUGROHO
PER/032/042011
01/04/2011
31/12/2011
2000
24
07263
BP MITRA 42 PACITAN
0857-28721618 63512
IR H.TEUKU ISMAIL
PER/020/012013
01/01/2013
31/12/2013
RI244010
7000
7000
PKR102001
Halaman :
Tanggal :
186/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/002/012013
01/01/2013
31/12/2013
7000
PER/007/012013
01/01/2013
31/12/2013
7000
DR INDAH PITARTI
PER/049/062012
01/01/2012
31/12/2012
DR NANIEK
PER/010/013013
01/01/2013
31/12/2013
7000
63252
DR PUJIONO
PER/011/012013
01/01/2013
31/12/2013
7000
0352-462379
63451
TITIK MARIJATI
PER/018/012013
01/01/2013
31/12/2013
7000
0351-462688
63152
PER/001/012013
01/01/2013
31/12/2013
7000
63552
PER/036/092009
01/09/2009
31/08/2010
200
07791
0351-383956
63153
PER/031/012012
01/01/2012
31/12/2012
7000
34
06687
JL PAHLAWAN NO 2 MAGETAN
0351-895023
63352
0351-895067
PER/029/012012
01/01/2012
31/12/2012
10000
35
06658
JL DR SOETOMO NO 59 MADIUN
0351-464325
63161
0351-458054
PER/028/012012
01/01/2012
31/12/2012
20000
36
07792
0351-749023
63252
0351-749023
PER/030/012012
01/01/2012
31/12/2012
20000
37
05934
0357-881410
63512
0357-883818
PER/032/012012
01/01/2012
31/12/2012
20000
38
08100
APOTEK GARUDA
0351-463364
63172
PER/001/082012
01/08/2012
31/07/2013
39
07313
OPTIK NUSA
0351-7845705 63352
NURSALIM
PER/042/012012
01/01/2012
31/12/2012
7000
40
07303
0351-461199
63151
PER/033/012012
01/01/2012
31/12/2012
7000
41
06342
0351-746462
63252
0271-893494
H PRANOTO
PER/006/012011
01/01/2011
31/12/2011
7000
42
05549
OPTIK SINAR
0357-885648
63512
BAMBANG T. PRABOWO
PER/036/012012
01/01/2012
31/12/2012
7000
43
01925
OPTIK TASIKMALAYA
0351-464230
63151
HOKMAN HARIS
PER/038/012012
01/01/2012
31/12/2012
7000
44
02610
JL P SUDIRMAN 43 MADIUN
0351-459072
63151
SUWARTININGSIH
PER/037/012013
01/01/2013
31/12/2013
7000
25
04196
26
05520
27
01919
DR INDAH PITARTI
28
02608
29
63151
0351-462439
BHAKTI NADINA
081-335492052 63153
0352-312100
63263
DR NANIEK JULIANY
0351-891888
63352
01911
DR. PUJIONO
0351-747960
30
04195
31
01909
32
05104
33
RI244010
7000
PKR102001
Halaman :
Tanggal :
187/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/080/012013
01/01/2013
31/12/2013
10000
PER/085/012013
01/01/2013
31/12/2013
7000
PER/086/012013
01/01/2013
31/12/2013
10000
DR SUWANTI SISWANTORO
PER/089/012013
01/01/2013
31/12/2013
70000
PER/079/012013
01/01/2013
31/12/2013
10000
UMRO'ATUN HILALIYAH
PER/087/012013
01/01/2013
31/12/2013
7000
DR WASINGAH
PER/084/012013
01/01/2013
31/12/2013
7000
66252
DR ABU MARDAH
PER/090/012013
01/01/2013
31/12/2013
10000
-0355878226
66351
PER/083/012013
01/01/2013
31/12/2013
7000
-0355793664
66373
PER/088/012013
01/01/2013
31/12/2013
7000
DR.HARIADI
0342-813851
66163
DR HARIADI
PER/078/012013
01/01/2013
31/12/2013
12000
06970
66252
DR H MUKSIN
PER/082/012013
01/01/2013
31/12/2013
10000
13
01926
0355-7191955 66263
DRG.AHMAD MUHTAR
PER/081/012013
01/01/2013
31/12/2013
12000
14
07740
RSI MUHAMMADIYAH
0355-532760
66274
0355-532760
ABU MARDAH
PER/091/012013
01/01/2013
31/12/2013
5000
15
07795
0355-331649
66252
0355-322593
PER/100/012013
01/01/2013
31/12/2013
16
06395
0342-801111
66151
PER/096/012013
01/01/2013
31/12/2013
10000
17
01935
66252
PER/098/012013
01/01/2013
31/12/2013
30000
18
07164
JL DR SUTOMO NO 2 TRENGGALEK
0355-791118
66351
0355-791118
RSUD DR SOEDOMO
PER/097/012013
01/01/2013
31/12/2013
20000
19
07732
RSU AN-NISAA
0342-692999
66183
0342-693999
SRI MUNTAMAH
PER/099/012013
01/01/2013
31/12/2013
20
03669
-0355324441
PER/056/012012
01/01/2012
31/12/2012
21
01942
22
07349
66352
AHMAD BISRI
PER/094/012013
01/01/2013
31/12/2013
23
07348
66252
AHMAD BISRI
PER/095/012013
01/01/2013
31/12/2013
24
04358
-0342-801804 66151
BUDI PRASETYO
PER/092/012013
01/01/2013
31/12/2013
7000
25
04359
-0342-335078
PER/093/012013
01/01/2013
31/12/2013
7000
26
0355-322609
PER/101/012013
01/01/2013
31/12/2013
06969
BP DHARMA HUSADA
66151
05308
DR BOEDI SOEGIONO
-081555727379 66151
DR BOEDI SOEGIONO
06972
66351
06259
DR SUWANTI SISWANTORO
-08123402654 66252
06356
DR TUTUT WAHYUNINGUMI R
0342-553528
66152
05306
DR UMRO'ATUN HILALIYAH
JL KALIWATU NO 10 PAKUNDEN
66151
05307
DR WASINGAH
66151
06971
05288
10
04096
11
05287
12
RI244010
66252
0355-322165
7000
7000
v
v
PKR102001
Halaman :
Tanggal :
188/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/05/012013
01/01/2013
31/12/2013
15000
PER/03/012013
01/01/2013
31/12/2013
7000
PER/17/102012
01/11/2012
31/12/2013
1500
DR SURIJATI
PER/15/102012
01/09/2012
31/12/2013
DR WIDYA KURNIA
PER/01/012012
01/01/2013
31/12/2013
7000
081-23256912 69151
DR YULIA MAYASIN SE
PER/04/012013
01/01/2013
31/12/2013
7000
081-23208872 69352
DR ARIE YANUAR R
PER/02/012013
01/01/2013
31/12/2013
7000
081-23056510 69352
DRG SOEVRIENI E. B
PER/03/122011
01/12/2011
31/12/2012
031-3091016
69155
PER/16/102012
01/09/2012
31/12/2013
01953
PUSKESMAS KOTA
031-77625063 69151
06859
DR IMELDA KRISNASARI
081-332882201 69452
DR IMELDA KRISNASARI
06047
DR INTAN RETNOSARI
081-8323413
69252
DR INTAN RETNOSARI
03987
DR SURYATI
081-331332648 69151
03785
DR WIDYA KURNIA
JL JOKOTOLE GG V NO 22 A PAMEKASAN
081-230792620 69315
05503
DR YULIA MAYASIN, SE
01945
06958
05935
RI244010
HARI BUKA
PPK II
v
v
7000
7000
PKR102001
Halaman :
Tanggal :
189/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
05025
PKM KAPAS
0353-885541
62152
05290
PUSKESMAS RENGEL
0356-811233
62364
05291
BP MITRA 10
0296-423669
58252
IR T. ISMAIL
03826
BP MITRA 5
0353-892665
62162
0321-878318
IR.T.ISMAIL
01932
BP MITRA 6
0356-321394
62353
0321-877187
IR .T.ISMAIL
01931
BP MITRA 8
0322-7722188 62252
IR. T. ISMAIL
06939
081-554747737 62252
05983
62252
07910
62152
10
07651
11
07652
12
07758
13
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/13/012013
01/01/2013
31/12/2013
PER/38/012012
01/01/2012
31/12/2012
PER/05/012013
01/01/2013
31/12/2013
10000
PER/01/012013
01/01/2013
31/12/2013
20000
PER/02/012012
01/01/2013
31/12/2013
10000
PER/04/012012
01/01/2013
31/12/2013
10000
PER/14/012013
01/01/2013
31/12/2013
7000
IR. T ISMAIL
PER/07/012013
01/01/2013
31/12/2013
7000
PER/10/012013
01/01/2013
31/12/2013
1000
62252
PER/06/012013
01/01/2013
31/12/2013
4000
-081335755898 62352
PER/03/012013
01/01/2013
31/12/2013
4000
62252
PER/01/03-2012
01/03/2012
31/12/2012
05023
0353-511731
62152
0353-511678
DR DIANA K
PER/12/012013
01/01/2013
31/12/2013
14
07759
62352
PER/02/032012
01/03/2012
31/12/2012
10000
15
03832
0322-321718
62257
16
03827
0356-321010
62352
17
03831
0353-881193
62152
18
04251
0353-883305
19
04252
20
06248
RI244010
v
v
7000
3000
7000
PER/44/012012
01/01/2012
31/12/2012
7000
PER/43/012012
01/01/2012
31/12/2012
10000
PER/42/012012
01/01/2012
31/12/2012
10000
62152
ABDUL MUNIF
PER/46/012012
01/01/2012
31/12/2012
7000
0322-321282
16414
NURSALIM
PER/47/012012
01/01/2012
31/12/2012
7000
0322-663508
62252
YAYASAN MUHAMAMDIYAH
PER/21/072009
01/07/2009
31/05/2010
4000
PKR102001
Halaman :
Tanggal :
190/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/15/012013
01/01/2013
31/12/2013
14000
PER/16/012013
01/01/2013
31/12/2013
7000
PER/23/012013
01/01/2013
31/12/2013
7000
PER/05/2013
01/01/2013
31/12/2013
10000
PER/06/012013
01/01/2013
31/12/2013
10000
61252
M ZAHIR SYAH
PER/24/012013
01/01/2013
31/12/2013
7000
-031-70004807 61252
PER/07/012013
01/01/2013
31/12/2013
10000
BP. JAMSOSTEK 57
-085231572758 61252
DR ARIF WIDODO
089675893657
PER/17/012013
01/01/2013
31/12/2013
9000
01981
BP. JAMSOSTEK 60
-031-8666334 61252
ZAKARIA
PER/14/012013
01/01/2013
31/12/2013
7000
10
01982
BP. JAMSOSTEK 61
-031-71345774 61252
DRA KUSMINARTI
PER/22/012013
01/01/2013
31/12/2013
11000
11
01989
BP. JAMSOSTEK 62
031-8985168
61252
T. ISMAIL
PER/10/2013
01/01/2013
31/12/2013
11000
12
01983
BP. JAMSOSTEK 63
031-71174532 61252
DR ARIF WIDODO
PER/18/012013
01/01/2013
31/12/2013
7000
13
01957
BP. JAMSOSTEK 75
-08283485419 61252
PER/08/012013
01/01/2013
31/12/2013
7000
14
01974
BP. JAMSOSTEK 9
-03170961434 61252
PER/04/012013
01/01/2013
31/12/2013
7000
15
01988
BP. JAMSOSTEK 94
KETIMANG NO 10 WONOAYU
-031-8852948 61252
MITRA HUSADA
PER/11/012013
01/01/2013
31/12/2013
7000
16
05106
031-77084935 61252
PER/30/012013
01/01/2013
31/12/2013
5000
17
07952
031-8679727
61274
031-8683181
PER/40/012013
01/01/2013
31/12/2013
1000
18
01964
-0811344394
61252
DR NANNY KATILI
PER/27/012013
01/01/2013
31/12/2013
7000
19
01972
-031-8548242 61252
ZAKARIA
PER/13/012013
01/01/2013
31/12/2013
10000
20
07379
61275
CV AS SYIFA
PER/35/012013
01/01/2013
31/12/2013
3000
21
07381
031-8929139
61233
031-8929123
M EDY WIYONO
PER/34/012013
01/01/2013
31/12/2013
3000
22
05337
031-8976448
61252
ASMIHAN FAUZI
PER/31/012013
01/01/2013
31/12/2013
5000
23
08067
031-28858998 61254
PER/41/012013
01/01/2013
31/12/2013
5000
24
04891
KLINIK RAHAYU
031-7886336
61252
SENIN
PER/29/012013
01/01/2013
31/12/2013
5000
25
07378
KLINIK SEHATI
031-77000977 61276
DR DINA MARIANI
PER/36/012013
01/01/2013
31/12/2013
3000
26
02605
-8673939
61252
DR SURANADI S
PER/19/012013
01/01/2013
31/12/2013
10000
27
04890
KLINIK TARRIZA
031-8686881
61252
MARIA SUTARNO C, SH
PER/28/012013
01/01/2013
31/12/2013
7000
01979
-031-8941924 61252
01987
-031-8963190 61252
01986
031-75166783 61252
H SUMARNO, SH
01975
BP. JAMSOSTEK 16
-08283474637 61252
01976
BP. JAMSOSTEK 17
-03170962434 61252
01977
BP. JAMSOSTEK 20
-031-363067
01978
BP. JAMSOSTEK 48
01980
UMUM (SHIFT 1)
RI244010
PKR102001
Halaman :
Tanggal :
191/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
28
01973
-031-8540790 61252
29
01985
-031-8830988 61252
30
07953
031-8976261
61263
31
01960
KRIYANDAS NURANI
031-58834704 61252
32
07955
031-8852735
33
01962
34
01984
35
06067
36
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/20/012013
01/01/2013
31/12/2013
11100
PER/21/012013
01/01/2013
31/12/2013
7000
PER/38/012013
01/01/2013
31/12/2013
1000
PER/26/012013
01/01/2013
31/12/2013
5000
DR ISKANDAR ALI
ANA SUSANTI
HARI BUKA
PPK II
031-8852735
SUMARDI,SE.MM
PER/37/012013
01/01/2013
31/12/2013
1000
-031-70388824 61252
DR TUTIK HANDAYANI
PER/25/012013
01/01/2013
31/12/2013
7000
-08885729551 61252
PER/09/012013
01/01/2013
31/12/2013
7000
031-972127
61252
AINI ULFAH
PER/32/012013
01/01/2013
31/12/2013
7000
06644
-081330304302 61233
DR H SUPARMAN,MM
PER/33/012013
01/01/2013
31/12/2013
3000
37
04683
POLIKLINIK PUCANG
61252
DR. INDAH P
PER/12/012013
01/01/2013
31/12/2013
5000
38
07954
RSIA KIRANA
031-7889805
61274
031-7873010
DR SETYABUDI PAMUNGKAS
PER/39/012013
01/01/2013
31/12/2013
1000
39
06538
0343-854258
61252
0343-852104
PER/50/012013
01/01/2013
31/12/2013
100
40
03287
PUSKESMAS KRIAN
61252
PER/45/012013
01/01/2013
31/12/2013
7000
41
03288
PUSKESMAS SUKODONO
61252
PER/46/012013
01/01/2013
31/12/2013
7000
42
01968
PUSKESMAS TAMAN
-0317881201
61252
PER/44/012013
01/01/2013
31/12/2013
7000
43
03289
PUSKESMAS WARU
61252
PER/47/012013
01/01/2013
31/12/2013
7000
44
03286
RS ANWAR MEDIKA
JL SEMAWUT BALONGBENDO
-SIDOARJO
61252
PER/43/012013
01/01/2013
31/12/2013
7000
45
01967
RSUD. SIDOARJO
031-8961649
61252
PER/42/012013
01/01/2013
31/12/2013
7000
46
07839
RS CITRA MEDIKA
0321-361000
61233
0321-361666
47
03925
RS MATA FATMA
031-71657072 61252
031-7879857
48
07214
031-8921233
61252
031-8944990
49
05848
031-8971747
61252
031-8971747
50
04667
OPTIK CAHAYA
61252
JOKO RENANTO
70
51
04684
61252
70
52
03927
APOTEK GAMA
61253
PER/53/012013
01/01/2013
31/12/2013
7000
53
06024
APOTIK REJEKI
JL KAHURIPAN NO 6 SIDOARJO
61276
PER/54/012013
01/01/2013
31/12/2013
10000
54
05017
APOTIK SURYANI
61252
PER/41/IKS/012010
01/01/2010
31/12/2010
7000
55
03930
OPTIK INDAH
61252
PER/57/012013
01/01/2013
31/12/2013
7000
56
06539
OPTIK MEDIA
JL GELURAN NO 53 TAMAN
031-77782903 61252
PER/61/012013
01/01/2013
31/12/2013
100
RI244010
61273
NOVA JOKO P
PER/52/012013
01/01/2013
31/12/2013
10000
PER/48/012013
01/01/2013
31/12/2013
7000
PER/51/012013
01/01/2013
31/12/2013
100
PER/49/012013
01/01/2013
31/12/2013
1000
PKR102001
Halaman :
Tanggal :
192/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
57
03931
OPTIK SAHABAT
61254
58
04668
OPTIK TERANG
61252
59
03928
OPTIK TIARA
61253
60
05461
031-8540790
61252
61
03933
LAB PERMATA
61252
62
06044
JL SULTAN AGUNG NO 20
031-8947457
63
01990
LABORATORIUM JENGGOLO
JL. JENGGOLO
64
65
66
RI244010
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
31/12/2013
7000
PER/59/012013
PER/60/012013
01/01/2013
31/12/2013
7000
PER/58/012013
01/01/2013
31/12/2013
7000
PER/35/IKS/012008
01/01/2007
31/12/2008
1000
PER/56/012013
01/01/2013
31/12/2013
7000
61252
PER/43/IKS/12010
01/01/2010
31/12/2010
7000
031-8964904
61257
PER/55/012013
01/01/2013
31/12/2013
7000
61252
PER/01/012013
01/01/2013
31/12/2013
JL.RAYA SURABAYA-MOJOKERTO KM 44
0321-361000
61265
0321-362956
PER/02/012013
01/01/2013
31/12/2013
JL KH SAMANHUDI NO 85
031-8962129
61233
031-8940633
PER/03/012013
01/01/2013
31/12/2013
SIDOARJO
SUPANDI
100
PKR102001
Halaman :
Tanggal :
193/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/09/012013
01/01/2013
31/12/2013
7000
PER/26/012013
01/01/2013
31/12/2013
7000
PER/03/012013
01/01/2013
31/12/2013
11500
DR. MUZAMMILA
PER/01/012013
01/01/2013
31/12/2013
10000
PER/02/012013
01/01/2013
31/12/2013
7000
031-71134815 61151
YUNI HIDAYATI
PER/05/012013
01/01/2013
31/12/2013
7000
-031-7506010
M. ZAHIR SYAH, SE
PER/06/012013
01/01/2013
31/12/2013
7000
031-34039950 61151
M. ZAHIR SYAH, SE
PER/06/012013
01/01/2013
31/12/2013
1210
01996
031-81849663 61162
PER/06/012013
01/01/2013
31/12/2013
7000
10
01992
BP. JAMSOSTEK 43
-031-7591575
M. ZAHIR SYAH, SE
PER/06/012013
01/01/2013
31/12/2013
7000
11
01994
BP. JAMSOSTEK 98
031-7993250
61121
PER/04/012013
01/01/2013
31/12/2013
10000
12
04364
031-71986778 61151
M. ZAHIR SYAH, SE
PER/06/012013
01/01/2013
31/12/2013
7000
13
07787
031-3990784
61171
DR. MUZAMMILA
PER/01/012013
01/01/2013
31/12/2013
7000
14
05111
031-3973095
61151
DR MUZAMMILA
PER/01/012013
01/01/2013
31/12/2013
7000
15
04366
031-3959905
61121
YUNI HIDAYATI
PER/05/012013
01/01/2013
31/12/2013
7000
16
06493
031-3942148
61151
031-3930548
DR. MUZAMMILA
PER/01/012013
01/01/2013
31/12/2013
7000
17
08022
031-81180888 61111
PER/36/012013
01/01/2013
31/12/2013
7000
18
08172
KLINIK KRISNA 2
031-3959134
031-3956615
DR.ADI WIJANTORO
PER/25/012013
01/01/2013
31/12/2013
7000
19
08049
031-88188554 61111
BAMBANG WIBISONO
PER/10/012013
01/01/2013
31/12/2013
7000
20
08021
031-7590406
61177
MOHAMMAD LUMAJI,ST
PER/35/012013
01/01/2013
31/12/2013
7000
21
02000
-031-7507007 61177
DAWAM RAHARJO,SE
PER/07/012013
01/01/2013
31/12/2013
7000
22
02001
-031-3978551
DAWAM RAHARJO,SE
PER/07/012013
01/01/2013
31/12/2013
10000
23
04674
031-60909997- 61151
60484128
PER/03/012013
01/01/2013
31/12/2013
7000
24
02002
PRIMA MEDIKA 78
-031-8979965 61151
M. ZAHIR SYAH, SE
PER/06/012013
01/01/2013
31/12/2013
10000
06727
031-8976315
61151
SUNARYO,ST,SH,MM
08173
BP AL HISYAM
031-7991659
61111
LATIF M.KES
03248
BP JAMSOSTEK 124
JL RA KARTINI GG IV 12
031-3981179
04367
BP JAMSOSTEK GKB
031-3959912
61151
05552
BP PANGLIMA SUDIRMAN
031-3980722
61151
04365
02004
01997
RI244010
61111
PKR102001
Halaman :
Tanggal :
194/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
25
07647
031-71364766 61171
26
01998
-031-3951239 61121
27
04377
031-3950552
61151
28
06026
RS DENISA
031-3950552
61151
031-3955209
29
06233
031-3978658
61151
30
07363
031-7406293
31
04428
32
03520
33
05112
34
HARI BUKA
PPK II
S
RS
APT
v
v
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/08/012013
01/01/2013
31/12/2013
PER/20/012013
01/01/2013
31/12/2013
7000
PER/22/012011
01/01/2011
31/12/2011
7000
PER/22/012013
01/01/2013
31/12/2013
7000
PER/23/012013
01/01/2013
31/12/2013
7000
60111
031-7404603
DR.H.M.FAIZ,SP THT-KL
PER/24/012013
01/01/2013
31/12/2013
031-3951239
61121
PER/21/012013
01/01/2013
31/12/2013
7000
031-3950243
61151
PER/14/012013
01/01/2013
31/12/2013
7000
031-3950552
61151
PER/18/012013
01/01/2013
31/12/2013
7000
01999
-031-3958955
PER/15/012011
01/01/2011
31/12/2011
7000
35
04379
-031-7590255 61151
DAMAN S.
PER/12/012013
01/01/2013
31/12/2013
7000
36
07573
OPTIK DOMAS
61151
MARDJI
PER/13/012013
01/01/2013
31/12/2013
37
03521
031-3984247
61151
NY RIANA
PER/14/012013
01/01/2013
31/12/2013
7000
38
04378
031-3958373
61151
NURSALIM
PER/11/012013
01/01/2013
31/12/2013
7000
39
08122
LABORATORIUM PARAHITA
031-3981455
61111
031-3991820
PER/17/012013
01/01/2013
31/12/2013
40
05113
LABORATORIUM DENISA
031-3950552
61151
DR BAMBANG PRIHADI
PER/16/012013
01/01/2013
31/12/2013
7000
41
03848
LABORATORIUM GREDIA
031-3983088
61121
YUDANINGSIH
PER/15/012013
01/01/2013
31/12/2013
7000
42
031-3951239
61151
031-3953535
PER/27/012013
01/01/2013
31/12/2013
7000
43
JL JEND A YANI 69
031-3976688
61151
031-3981232
PER/28/012013
01/01/2013
31/12/2013
10000
RI244010
v
v
PKR102001
Halaman :
Tanggal :
195/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/12/012013
01/01/2013
31/12/2013
10000
PER/14/012013
01/01/2013
31/12/2013
30000
PER/15/012013
01/01/2013
31/12/2013
15000
SARTIKA CV
PER/10/012013
01/01/2013
31/12/2013
10000
SARTIKA CV
PER/09/012013
01/01/2013
31/12/2013
12000
031-70435551 60111
SARTIKA CV
PER/08/012013
01/01/2013
31/12/2013
10000
031-7670530
60111
PER/07/012013
01/01/2013
31/12/2013
12000
031-7405565
60111
031-3293721
PER/06/012013
01/01/2013
31/12/2013
20000
02012
031-7404819
60111
PER/13/012013
01/01/2013
31/12/2013
10000
10
04537
031-7672082
60111
PER/11/012013
01/01/2013
31/12/2013
10000
11
04538
RB PUTRI RAHAYU
031-7672082
60111
PER/11/012013
01/01/2013
31/12/2013
7000
12
94741
RS BHAKTI RAHAYU
031-8289668
60111
031-8293839
PT BHAKTI RAHAYU
PER/05/012013
01/01/2013
31/03/2013
10000
13
94740
RS BUNDA SURABAYA
031-7409436
60112
031-7442133
PER/04/012013
01/01/2013
31/03/2013
7000
14
07296
RS MUJI RAHAYU
031-7418889
60111
PER/02/012013
01/01/2013
31/03/2013
15
06905
RS WIJAYA
031-7523087
60228
031-7525660
YAYASAN WIJAYA
PER/03/012013
01/01/2013
31/03/2013
16
04741
031-8295922
60111
PER/17/092008
01/09/2008
31/12/2008
17
04740
RS. BUNDA
60111
18
07679
OPTIK ANUGERAH
031-8293839
60231
19
031-8289668
60111
031-8293839
20
031-7440077
60243
031-7442133
21
031-7418889
60111
22
031-7523087
60228
031-7526660
02011
BP KEBANGKITAN
031-71258886 60111
KEMBANG TANJUNG CV
02019
031-5675589
60111
02010
031-7417956
60111
031-7417956
DINAYLA UTAMA CV
02014
BP. JAMSOSTEK 44
031-70435551 60111
02007
BP. JAMSOSTEK 59
02016
BP. JAMSOSTEK 77
02013
02005
RI244010
7000
PER/01/012013
01/01/2013
31/12/2013
PT BHAKTI RAHAYU
PER/13/012012
01/01/2012
31/12/2012
PER/14/012012
01/01/2012
31/12/2012
PER/17/012013
01/01/2013
31/12/2013
PER/15/012012
01/01/2012
31/12/2012
YAYASAN WIJAYA
7000
7000
7000
PKR102001
Halaman :
Tanggal :
196/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/04/012012
01/03/2012
28/02/2013
10000
PER/10/012012
01/03/2012
28/02/2013
7000
PER/07/012012
01/03/2012
28/02/2013
10000
DAWAM RAHARJO
PER/05/012012
01/03/2012
28/02/2013
7000
DR TJAHJONO TANDJOENG
PER/06/012012
01/03/2012
28/02/2013
10000
60177
082.894.000.20
1
FARAH TAMALIA
PER/09/012012
01/03/2012
28/02/2013
7000
031-70125761 60175
DR RR KARTI WIATMINI
PER/08/012012
01/03/2012
28/02/2013
7000
031-51500111 60111
PER/26/122012
01/01/2013
31/12/2013
10000
07064
031-3761150
PER/28/122012
01/01/2013
31/12/2013
10000
10
07063
RB "WISMA HUSADA"
031-51500111 60111
PER/27/122012
01/01/2013
31/12/2013
14000
11
05115
RS AL IRSYAD SURABAYA
031-3531223
60162
031-3541517
YYSN RS AL IRSYAD
PER/22/092012
01/09/2012
31/08/2013
7000
12
05116
OPTIK INDOJAYA
031-35566636 60161
031-5476907
RUDI LIMSA
PER/12/012012
01/01/2012
31/12/2012
13
04414
OPTIK TIDAR
031-5483741
60251
PER/36/122012
01/01/2013
31/12/2013
7000
14
07429
JL PRAMBANAN 01
031-5053031
61253
031-5053032
HARI PURNOMO
PER/21/082012
01/08/2012
31/07/2013
10000
15
0700000000012 RS AL-IRSYAD
031-3531223
60162
031-3541517
DR AHMAD BAKARMAN
PER/24/102012
01/11/2012
30/10/2013
16
0700000000011 RS PHC
031-3294801
60121
031-3294804
DR WIDORIN SOENARJO
PER/13/082008
01/10/2009
30/10/2010
02737
BP JAMSOSTEK 1
031-3556937
60165
DAWAM RAHARJO
03273
BP JAMSOSTEK 121
031-3714637
60135
RAHMAT WAHYUDI
02741
BP JAMSOSTEK 122
031-3763232
60134
EDYANTOMO
02738
BP JAMSOSTEK 3
031-5343154
60182
03272
BP JAMSOSTEK 41
031-3764782
60136
02740
BP JAMSOSTEK 93
04318
BP RAJAWALI
07062
RI244010
60111
HASAN BASRI SE
v
v
PKR102001
Halaman :
Tanggal :
197/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/05/122012
01/01/2013
31/12/2013
7000
PER/01/122012
01/01/2013
31/12/2013
7000
PER/02/122012
01/01/2013
31/12/2013
7000
RAHMAD WAHYUDI
PER/02/122012
01/01/2013
31/12/2013
7000
RAHMAD WAHYUDI
PER/02/122012
01/01/2013
31/12/2013
7000
031-8721711
RR KARTI WIATMINI
PER/03/122012
01/01/2013
31/12/2013
7000
-031-8706755 60000
ZAKARIA ABDULLAH
PER/04/122012
01/01/2013
31/12/2013
7000
031-70932808 60122
031-8438809
PER/06/122012
01/01/2013
31/12/2013
14000
031-8700691
60111
ZAKARIA ABDULLAH
PER/04/122012
01/01/2013
31/12/2013
7000
05369
RB YAYUK ISMAIL
031-8712788
60111
031-8416845
YAYUK ISMAIL
01/01/2013
31/12/2013
7000
11
07105
60111
PER/08/122012
01/01/2013
31/12/2013
7000
12
08012
RS ROYAL SURABAYA
031-8476111
60111
031-8476211
PER/27/112012
01/11/2012
31/12/2013
7000
13
04818
-0318292384
60111
PER/15/122012
01/01/2013
31/12/2013
100000
14
05188
JL JEMURSARI 51-57
031-8471877
60111
031-8414877
PER/14/122012
01/01/2013
31/12/2013
1000000
15
04822
OPTIC MERLIN
60111
NORMA LUCAS SE
PER/13/122012
01/01/2013
31/12/2013
14000
16
04821
OPTIK SAHABAT
60111
IRWAN CAHYONO
PER/12/122012
01/01/2013
31/12/2013
14000
17
06814
PER/09/122012
01/01/2013
31/12/2013
70000
18
04820
LABORATORIUM KLINIK PRATAMA "DIALISA" RUKO SURYA INTI PERMATA JL JEMUR ANDAYANI 50 BLOK D 031-8496767
NO 33-35
60111
031-8496767
PER/11/122012
01/01/2013
31/12/2013
14000
19
06638
031-8720733
60111
031-8713550
HENDRATNO TJAHJADI
PER/10/122012
01/01/2013
31/12/2013
14000
20
031-
60111
PER/03/092012
01/09/2012
31/08/2013
10000
21
JL A. YANI 2-4
031-8284505
60111
031-8284486
YARSIS
PER/02/082012
01/08/2012
31/07/2013
70000
22
JL JEMURSARI 51-57
031-847187778 60111
031-8414877
YARSIS
PER/26/082012
01/08/2012
31/07/2013
7000
07639
BP AT-TAUFIQ
031-8412124
03266
BP DYNAILA UTAMA 81
03263
BP NURANI JAYA 37
03265
60111
031-8492063
-031-8419906 60111
SITI MURIYAH
031-8483147
60111
031-8483147
RACHMAD WAHYUDI
BP NURANI JAYA 66
031-8473668
60111
031-8473668
03267
BP NURANI JAYA 83
031-8713409
60111
03262
BP WIDYA MANDIRI 1
60111
03260
06810
03261
10
RI244010
031-70932808 60111
031-8438809
PKR102001
Halaman :
Tanggal :
198/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
05914
0562-631798
78351
DR H BERLI HAMDANI
06191
JL ALIANYANG NO 121
78351
06092
JL DI PANJAITAN NO 40 KETAPANG
78852
06193
78351
06187
JL APEL RT 04/ RW 09 NO 62
07097
06189
06188
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/41/042012
01/05/2012
30/04/2013
7000
DR HM CHONIDI A, MPH
PER/11/022009
01/03/2009
28/02/2010
7000
PER/41/042012
01/05/2012
30/04/2013
7000
78351
PER/41/042012
01/05/2012
30/04/2013
7000
78552
PER/07/012012
01/02/2012
31/01/2013
7000
78351
DRG MULTI,MPPM
PER/41/042012
01/05/2012
30/04/2013
7000
JL PURNAMA RT 02/ RW 20
78351
PER/41/042012
01/05/2012
30/04/2013
7000
04653
-081345496536 78351
SAMSUL HADI
PER/44/042012
01/05/2012
30/04/2013
7000
10
07807
0812-5761453 78351
SUPRATMAN
PER/18/022012
01/03/2012
28/02/2013
7000
11
06190
78351
PER/41/042012
01/05/2012
30/04/2013
7000
12
06091
JL A YANI NO 59 SANGGAU
78552
PER/23/032012
01/03/2012
28/02/2013
7000
13
07184
0561-768935
78351
SRI LESTARI
PER/43/042012
01/05/2012
30/04/2013
7000
14
06973
78355
PER/132/112012
01/01/2013
31/12/2013
7000
15
04467
-056424177
78124
PER/22/032012
01/03/2012
28/02/2013
7000
16
06192
JL TANJUNG RAYA II
78351
PER/41/042012
01/05/2012
30/04/2013
7000
17
04466
PUSKESMAS SOSOK
-056328831
78552
PER/06/012012
01/02/2012
31/01/2013
7000
18
02195
78124
DR MANGARAJA H
PER/113/092012
01/10/2012
30/09/2013
7000
19
05326
78351
R EPESUS NYARONG
PER/139/122012
01/01/2013
31/12/2013
7000
20
07093
78852
DR HM CHONIDI A, MPH
PER/12/022012
01/02/2012
31/01/2013
7000
21
07693
DR MIRA R (PEMANGKAT)
JL PEMBANGUNAN-PEMANGKAT
0812-5664727 79153
DR MIRA RAHMAWATI
PER/131/112012
01/01/2013
31/12/2013
22
07790
DR NIKEN Y (ANJUNGAN)
0561-7909606 78351
DR NIKEN
PER/19/022012
01/03/2012
28/02/2013
7000
23
07913
0812-75292936 78572
PER/28/032012
01/06/2012
31/05/2013
7000
24
07317
DR SAHAERUL FS (PINYUH)
0821-54326664 78351
DR SAHAERUL FS
PER/42/042012
01/05/2012
30/04/2013
7000
25
07094
DR SUPARTO
0813-5753581 78852
DR SUPARTO
PER/10/022012
01/02/2012
31/01/2013
7000
26
07972
78351
DR BARITA P OMPUSUNGGU
PER/102/072012
01/09/2012
31/08/2013
7000
27
06382
DR. DIONO
78351
DR DIONO
PER/119/102012
01/11/2012
31/10/2013
7000
RI244010
PER/122/102012
01/09/2012
31/08/2013
7000
7000
PKR102001
Halaman :
Tanggal :
199/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
SABTU
28
08169
JL DR WAHIDIN SUDIROHUSODO NO 8F
0812-56109043 78111
PER/140/122012
01/01/2013
31/12/2013
7000
29
02191
78351
DR FAISAL L
PER/133/112012
01/01/2013
31/12/2013
7000
30
02188
78124
DR HENDRO W
PER/136/112012
01/01/2013
31/12/2013
8700
31
07956
0561-735073
78351
0561-735075
PER/64/062012
01/06/2012
31/05/2013
7000
32
07407
0811-577162
78351
DR KARIDA SALIM
PER/68/072012
01/07/2012
30/06/2013
7000
33
07092
DR. SJ SINAMBELA
0813-45028378 79151
DR SJ SINAMBELA
PER/06/012011
01/02/2011
31/01/2012
34
02187
-0561-767005 78124
DR WIDI R
PER/111/092012
01/10/2012
30/09/2013
8500
35
02192
DR. ZUHAIRIAH
78124
DR ZUHAIRAH
PER/135/112012
01/01/2013
31/12/2013
7000
36
07095
0812-5753581 78852
PER/11/022012
01/02/2012
31/01/2013
7000
37
06661
0815-22689659 78351
PER/54/052012
01/06/2012
31/05/2013
7000
38
05661
JL JEND URIP NO 11
0816-4988892 78351
PER/67/072012
01/07/2012
30/06/2013
13000
39
04649
-0561-731027 78124
PER/66/072012
01/07/2012
30/06/2013
7000
40
07096
0813-45389598 79151
PER/11/012011
01/02/2011
31/01/2012
41
02196
DRG. ABRAL
78351
DRG ABRAL
PER/110/092012
01/10/2012
30/09/2013
10650
42
06994
0561-7907912 78351
DRG ADE D
PER/134/112012
01/01/2013
31/12/2013
7000
43
03850
KLINIK BAHAGIA
-0561-723272 78351
DR LALU R
PER/109/092012
01/10/2012
30/09/2013
7000
44
05032
DR. SUNARDI
78351
DR. SUNARDI
45
05911
RS BHAYANGKARA PONTIANAK
JL. KS TUBUN
78351
0561-735511
DRG. SUGIYATO
PER/104/082012
01/09/2012
31/08/2013
7000
46
05913
JL ADI SUCIPTO
78351
PER/103/082012
01/09/2012
31/08/2013
7000
47
04634
78351
PER/45/092011
01/07/2011
30/06/2012
7000
48
06973
78355
PER/132/112012
01/01/2013
31/12/2013
7000
49
02201
78124
PER/37/042012
01/03/2012
28/02/2013
7000
50
06383
JL DI PANJAITAN NO 51 KETAPANG
78852
DRG DJOKO, MM
PER/39/082009
01/09/2009
31/08/2010
7000
51
05172
78351
PER/122/102012
01/09/2012
31/08/2013
7000
52
05089
RSUD SANGGAU
78552
PER/65/062012
01/06/2012
31/05/2013
7000
RI244010
PKR102001
Halaman :
Tanggal :
200/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
53
07587
RS FATIMA KETAPANG
0534-32814
78852
DR. INDAH
54
07318
0562-631791
78351
DR ROBERT
55
07588
JL P DIPONEGORO NO 5, SINGKAWANG
0852-45099282 78351
56
06384
78351
57
07054
0561-732101
58
06194
59
07912
APOTEK MEDISKA
60
06604
61
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/93/072012
01/08/2012
31/07/2013
PER/515/062012
01/05/2012
30/04/2013
7000
MAIMUNAH
PER/123/122012
01/12/2012
30/11/2013
7000
DR PENDI, MKES
PER/121/102012
01/11/2012
31/10/2013
7000
78351
0561-733623
PER/39/042012
01/02/2012
31/01/2013
7000
78351
PER/96/072012
01/05/2012
30/04/2013
78351
BF SURYANTO
PER/53/052012
01/06/2012
31/05/2013
APOTEK SINGKAWANG
78351
FELIX F
PER/03/032010
01/04/2010
31/03/2011
7000
02203
APOTIK PEMUDA
JL ANTASARI NO 92 PONTIANAK
78124
DR HENDRO W
PER/138/112012
01/01/2013
31/12/2013
7000
62
06381
0561-734799
78351
LINGGARYANTO B.U
PER/95/072012
01/09/2012
31/08/2013
63
04143
OPTIK MALAKA
-0561-765087 78351
ALIDJAYA M
PER/137/112012
01/01/2013
31/12/2013
RI244010
7000
PKR102001
Halaman :
Tanggal :
201/239
15-01-2013
16:22:40
PEMILIK
NO
NO. PPK
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
02213
0813-48868978 70661
04710
0511-525180
70675
06812
-085245374112 70552
02211
0815-21939341 70655
02210
0813-48174545 70661
DR MANAFAR H. SIREGAR
08167
DR AFRI AMORRINTO
0511-3358693 70114
08091
71452
08107
DR AULIA RACHMAN
07308
10
02206
11
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/14/052012
01/05/2012
30/04/2013
PER/13/082007
20/08/2007
19/08/2008
PER/38/092012
01/09/2012
31/08/2013
3500
PER/61/112012
01/11/2012
31/12/2013
3500
PER/51/092012
01/09/2012
28/02/2013
3500
DR AFRI AMORRINTO
PER/69/122012
01/01/2013
31/12/2013
3500
PER/47/102012
01/11/2012
31/12/2013
3500
70871
DR AULIA RACHMAN
PER/50/102012
01/11/2012
31/12/2013
3500
-08125199696 70652
PER/58/112012
01/11/2012
31/12/2013
3500
0816-4567061 70661
DR MUDI HANDAYANI
PER/35/08/2012
01/09/2012
31/08/2013
3500
06697
0526-2028412 71572
PER/19/062012
01/07/2012
30/06/2013
3500
12
06750
DR HJ SRI PRAMUDIAN K
0511-3261113 70652
000-
DR HJ SRI PRAMUDIAN K
PER/32/082012
01/09/2012
31/08/2013
3500
13
07050
DR HM IKHSAN RISWANDA
0511-4772678 70675
DR HM IKHSAN RISWANDA
PER/22/072012
01/08/2012
31/07/2013
3500
14
07590
0813-48942224 72181
PER/08/032012
01/03/2012
28/02/2013
3500
15
07185
DR JAUHARI RAHMANI
-081349420706 70852
DR JAUHARI RAHMANI
PER/03/012012
01/01/2012
31/12/2012
3500
16
07052
DR LAILATUL JANNAH
-087815142819 70652
DR LAILATUL JANNAH
PER/29/082012
01/08/2012
31/07/2013
3500
17
07629
DR LUSIANA RAFAELAH R
71152
DR LUSIANA RAFAELAH R
PER/10/03/2012
01/04/2012
31/03/2013
3500
18
07012
DR MAYA JUNIARTI
DR MAYA JUNIARTI
PER/88/122011
01/01/2012
31/12/2012
3500
19
06745
DR NANDA S.A.Y.U
06208125043200
000-000
DR NANDA S.A.Y.U
PER/17/072010
05/07/2010
04/07/2011
20
06873
0511-7130424 70652
0-0
PER/60/11/2012
01/11/2012
31/12/2013
3500
21
07222
DR RIYAN MAULANA
DR RIYAN MAULANA
PER/46/102012
01/10/2012
31/12/2013
3500
22
04699
PER/09/03/2012
01/04/2012
31/03/2013
3500
23
07440
DR SYAHRIZAL HAFIDZ
-082159030133 70852
DR SYAHRIZAL HAFIDZ
PER/12/042012
01/05/2012
30/04/2013
3500
24
06698
0526-2024326 71552
PER/18/062012
01/07/2012
30/06/2013
3500
PER/40/092012
01/09/2012
31/08/2013
3500
71352
RI244010
v
v
35000
3500
PKR102001
Halaman :
Tanggal :
202/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
25
02217
0813-51343405 70661
26
02212
0812-5113456 70661
PER/37/092012
01/09/2012
31/08/2013
3500
27
02207
0511-7227101 70124
DR YAYUK SUSMIATI
PER/11/032012
01/04/2012
31/03/2013
3500
28
02215
0812-5043835 70661
DR HUSIAN LANJANG
PER/30/082012
01/12/2013
31/12/2013
3500
29
02214
0811-516258
71571
DR MADE ASTAWA
PER/33/082012
01/09/2012
31/08/2013
3500
30
06586
0812-51319802 70652
PER/43/102012
01/10/2012
31/12/2013
3500
31
06541
PER/34/082012
01/09/2012
31/08/2013
3500
32
02216
0811-501466
70661
PER/36/082012
01/09/2012
31/08/2013
3500
33
06585
0819-52829202 71552
PER/44/102012
01/10/2012
31/12/2013
3500
34
06597
0818-03044682 70652
PER/42/092012
01/10/2012
30/09/2013
3500
35
02209
0812-5103678 70611
PER/45/092012
01/09/2012
31/12/2013
3500
36
07548
DR.DIANA BAKTI
0818-02747217 71152
DR.DIANA BAKTI
PER/59/112012
01/11/2012
31/12/2013
3000
37
06540
0813-49777143 71152
PER/39/092012
01/09/2012
31/08/2013
3500
38
06137
DR.R.M.NUR HARYONO N
-08125197704 70852
DR.R.M.NUR HARYONO N
PER/07/022012
01/03/2012
28/02/2013
3500
39
07936
JL. AHMAD YANI KM. 37,5 NO. 19 RT.009 RW.004 KEL. SUNGAI PARING KEC. MARTAPURA KAB. BANJAR
70661
PER/17/052012
01/06/2012
31/12/2012
3500
40
07061
-081331005800 70711
PER/31/08/2012
01/08/2012
31/07/2013
7000
41
07065
-08125026485 70652
PER/23/07/2012
01/08/2012
31/07/2013
7000
42
06784
-081528876504 71552
000-000
PER/41/082012
01/08/2012
31/07/2013
7000
43
06772
DRG NOVRIANTI
000-0000
DRG NOVRIANTI
PER/24/072012
01/08/2012
31/07/2013
44
06696
DRG SUDIRMAN
0526-2028412 71573
DRG SUDIRMAN
PER/14/072010
01/07/2010
30/06/2011
7000
45
07549
DRG.ISMIYATI
0821-56504115 71352
DRG.ISMIYATI
PER/62/112012
01/11/2012
31/12/2013
5000
46
07937
0511-21082
0511-21720
PER/05/012012
01/01/2012
31/12/2012
47
05437
0511-3300741 70661
RS DR.H.MOCH.ANSARI SALEH
PER/13/052012
01/04/2012
31/12/2012
7000
48
02208
JL A. YANI NO 1 KM 1, BANJARMASIN
0511-3252180 70661
0511-3252229
PER/49/092012
01/09/2012
31/12/2013
7000
49
07273
0526-2022550 71571
0526-2024122 PT PERTAMINA
PER/20/072012
01/04/2012
31/03/2013
15000
RI244010
70881
DR AGUSTINA RAHMAH
KAMIS, JUM'AT,
SABTU
7000
PKR102001
Halaman :
Tanggal :
203/239
15-01-2013
16:22:40
PEMILIK
NO
NO. PPK
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
50
04774
0511-3354827 70661
NOORBEK SALEH
51
94774
NOORBEK SALEH
RI244010
70652
POLA PEMBIAYAAN
JAM BUKA
NO IKS
PER/16/06/2012
JUMLAH
TTG
31/05/2013
7000
7000
PKR102001
Halaman :
Tanggal :
204/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
05668
JL HM ARSYAD NO 65
0531-21010
74353
0531-21782
RSUD SAMPIT
07921
DR APRILIA HIDAYANI
74353
DR APRILIA HIDAYANI
07828
DR CANDRA ERIYANTO
JL RA KARTINI NO 60 SAMPIT
0813-28444664 74353
DR CANDRA
05944
DR IMAN
JL MANGGA NO 1 SAMPIT
0856-1557803 74353
08130
0821-5677733 74311
03499
DR ROSALINA
0811-528644
08001
DR YULITA HANDAYANI
02219
9
10
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/12/122011
01/01/2012
31/12/2012
PER/05/062012
01/06/2012
31/05/2013
3500
PER/07/092012
01/10/2012
31/03/2013
7000
DR IMAN
PER/12/122012
01/01/2013
31/12/2013
3750
DR NOOR ASSYIFA Z
PER/08/112012
01/12/2012
31/12/2013
74353
DR ROSALINA
PER/11/122012
01/01/2013
31/12/2013
0853-48816999 74261
DR YULITA HANDAYANI
PER/06/072012
01/08/2012
31/12/2012
3500
JL HM ARSYAD NO 65 SAMPIT
0531-053121010
74353
PER/11/122011
01/01/2012
31/12/2012
7000
06479
JL HM ARSYAD NO 120
0531-24828
74353
0531-24828
PER/09/122012
01/01/2013
31/12/2013
10000
04309
APOTIK BORNEO
JL HM ARSYAD SAMPIT
0536-6703902 74353
PER/01/012009
01/01/2009
31/12/2009
7000
RI244010
v
KIMIA FARMA PT
v
v
v
v
3000
3500
PKR102001
Halaman :
Tanggal :
205/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/007/032012
01/04/2012
31/03/2013
2000
PER/016/092012
01/11/2012
31/10/2013
7000
HERMAN
PER/002/032012
01/04/2012
31/03/2013
5000
DR IRWANSYAH
PER/001/012012
01/03/2012
28/02/2013
7000
DR MARDALENA
PER/020/112012
01/01/2013
31/12/2013
7000
0518-7700666 72113
081342703367
DR MOHAMMAD IQBAL
PER/003/032012
01/04/2012
31/03/2013
7000
-081348122411 72171
PER/022/112012
01/01/2013
31/12/2013
7000
DRG MEIYANTI
DRG MEIYANTI
PER/023/112012
01/01/2013
31/12/2013
7000
03855
KLINIK SAIJAAN
0518-21579
72117
H HASANUDDIN PAREWASI
PER/025/112012
01/01/2013
31/12/2013
7000
10
04798
72171
11
04244
-0512-61135
72172
PER/012/112011
01/01/2012
31/12/2012
7000
12
03865
RSU KOTABARU
-0518-21118
72152
PER/024/112012
01/01/2013
31/12/2013
7000
13
04245
APOTIK RIDHO
-081349459136 72172
SUPIANOR,SMIP,SPD
01/02/2009
31/12/2009
7000
14
03864
OPTIKAL MATAHARI
JL SINGABANA NO 13
-0518-23417
GAZALI RAHMAN
PER/010/122009
01/02/2010
31/12/2010
7000
06589
72152
DR KUNCA SUSETYA
04562
0518-38800
72154
DR WAHYUDI KUNCORO
07752
DR HERMAN
0852-57108881 72111
05413
DR IRWANSYAH
72171
05955
DR MARDALENA
07753
DR MOHAMMAD IQBAL
04241
04242
RI244010
72152
70
v
v
PKR102001
Halaman :
Tanggal :
206/239
15-01-2013
16:22:40
PEMILIK
NO
NO. PPK
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/02/012012
20/01/2012
31/01/2013
10000
PER/05/022012
01/02/2012
31/01/2013
15000
PER/25/122012
01/01/2013
31/12/2013
20000
PER/10/042012
01/05/2012
30/04/2013
10000
PER/01/012012
01/02/2012
31/01/2013
4000
PER/16/082012
01/10/2012
30/09/2013
7000
PER/24/122012
01/01/2013
31/12/2013
4000
01/11/2012
31/10/2013
4000
PER/11/042012
01/05/2012
30/04/2013
3000
0536-3221520 73111
POLDA KALTENG
PER/02/012012
20/01/2012
31/01/2013
10000
JL TAMBUN BUNGAI NO 4
0536-3308671 73111
PER/05/022012
01/02/2012
31/01/2013
20000
0513-23791
PER/25/122012
01/01/2013
31/12/2013
20000
07712
0526-2091235 73661
PER/10/042012
01/05/2012
30/04/2013
20000
14
06513
APOTEK AESCULAP
0536-3354244 73111
YANSON TANGKASIANG
PER/07/032012
01/05/2012
30/04/2013
20000
15
07428
73552
KOPERASI RSUD
PER/12/062012
01/06/2012
31/05/2013
20000
16
02222
-0536-22625
73111
SUPARTO
PER/08/032012
01/06/2012
31/05/2013
7000
07088
0536-3221520 73111
05439
JL TAMBUN BUNGAI NO 04
0536-3308671 73111
07157
0513-23791
PEMKAB KAPUAS
07722
0526-2091235 73661
06501
PUSKESMAS TANGKILING
0536-3349295 73111
DINKES PALANGKARAYA
04995
0536-3382712 73111
07009
0812-5003233 73552
06899
0813-52737188 73111
07711
73661
10
06900
RS BHAYANGKARA TK IV PALANGKARAYA
11
02224
12
07010
13
RI244010
73552
73552
PEMKAB KAPUAS
PKR102001
Halaman :
Tanggal :
207/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER / 30 / 092012
01/09/2012
28/02/2013
2000
PER / 37 / 122012
01/12/2012
31/05/2013
5000
PER / 31 / 092012
01/09/2012
28/02/2013
1000
PER / 25 / 072012
01/07/2012
31/12/2012
1000
DR NOVIYANI LEKSOMONO
PER / 01 / 012013
01/01/2013
30/06/2013
10000
DR NURHIDAYAT AFIANTO
PER / 24 / 072012
01/07/2012
31/12/2012
1000
74161
SUYUTI SYAMSUL
PER / 21 / 062012
01/06/2012
31/05/2013
0812-4445271 74181
DR TOMMY MONGDONG
PER / 29 / 092012
01/09/2012
28/02/2013
5000
DR YORDAN PRADIKSA
0812-28178910 74152
DR YORDAN PRADIKSA
PER / 28 / 092012
01/09/2012
28/02/2013
2000
04121
DRG INDRAWAN S
74152
DRG INDRAWAN S
PER / 23 / 072012
01/07/2012
30/06/2013
11
05063
JL SUTAN SYAHRIR NO 17
0532-21238
74161
0532-23581
PER / 02 / 012012
01/01/2012
31/12/2012
7000
12
07695
RSUD LAMANDAU
74164
PER / 06 / 012012
01/01/2012
31/12/2012
10000
13
07701
RSUD SUKAMARA
74171
PEMDA SUKAMARA
01/01/2012
31/12/2012
10000
14
07593
APOTEK HASANUDIN
JL HASANUDIN NO 03
08125-0931655 74152
APOTEK HASANUDIN
PER / 36 / 112012
01/11/2012
31/10/2013
5000
15
04122
APOTIK MODERN
16
07482
OPTIK NASIONAL
JL P ANTASARI NO 23
0811-528430
06835
DR ASMAWATI
08134-9088118 74152
DR ASMAWATI
07916
DR AZHAR KURNIAWAN
0812-51421782 74162
DR AZHAR KURNIAWAN
07531
DR DWI ASTUTI
0813-25226580 74171
DR DWI ASTUTI
07435
0852-51421111 74162
08170
DR NOVIYANI LEKSOMONO
JL HASANUDIN NO 3
0813-26793985 74113
07436
DR NURHIDAYAT AFIANTO
0812-2555155 74162
04120
DR SUYUTI MPPM
07799
DR TOMMY MONGDONG
06834
10
RI244010
74152
5000
7000
7000
v
H HUSIN EFFENDY
PER / 27 / 082012
01/08/2012
31/07/2013
5000
PKR102001
Halaman :
Tanggal :
208/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
07071
JL RAYA BALIKPAPAN-HANDIL II
75562
07556
PKM KERANG
76284
02244
04598
PKM PETUNG
02236
PKM SAMBOJA
06838
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/100/122011
01/02/2012
31/01/2013
7000
PER/20/092012
01/10/2012
30/09/2013
7000
75381
PER/31/122012
01/01/2013
31/12/2013
9500
0542-702737
76144
PER/77/122011
01/01/2012
31/12/2012
7000
SAMBOJA BALIKPAPAN
75381
PER/33/122012
01/01/2013
31/12/2013
7000
CV PRIMA MEDIKA
JL JEND SUDIRMAN NO 15
0543-23529
76252
DEANITA MANDASARI
PER/21/092012
01/11/2012
31/10/2013
7000
06166
0542-441362
76111
PER/08/062012
01/07/2012
30/06/2013
9000
02233
76111
PER/18/092012
01/10/2012
30/09/2013
08177
76113
PER/02/012013
01/01/2013
31/12/2013
7000
10
06734
DR MERIAH YACOBI
0542-5611165 76125
DR MERIAH YACOBI
PER/12/062012
01/07/2012
30/06/2013
7000
11
07653
DR RATNA SUDARTI
76114
PER/06/062012
01/07/2012
30/06/2013
7000
12
07964
76114
PER/14/072012
01/07/2012
30/06/2013
7000
13
02225
76111
PER/36/122012
01/01/2013
31/12/2013
7000
14
02230
DR. ANDI SJ
76111
PER/34/122012
01/01/2013
31/12/2013
8000
15
02227
76111
PER/38/122012
01/01/2013
31/12/2013
7000
16
02229
DR. BALERINA JP
76111
PER/37/122012
01/01/2013
31/12/2013
7000
17
02234
76111
PER/22/092012
01/10/2012
30/09/2013
7000
18
02226
76111
PER/35/122012
01/01/2013
31/12/2013
9000
19
07087
JL MAYJEN SUTOYO RT 39 NO 38
76115
PER/15/082012
01/08/2012
31/07/2013
9000
20
07856
0542-746077
76114
PER/02/042012
17/04/2012
31/03/2013
9000
21
03270
76111
PER/24/092012
01/10/2012
30/09/2013
9000
22
08134
76113
PER/27/122012
01/12/2012
30/11/2013
9000
23
08178
76252
PER/01/012013
01/01/2013
31/12/2013
9000
24
08025
DRG WULYANSARI
76111
PER/16/082012
01/08/2012
31/07/2013
9000
RI244010
DR TITANIA LESTARIANTI
ARDHIPUTRI
7000
PKR102001
Halaman :
Tanggal :
209/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
25
02240
DRG. BUDIANA
76111
26
06227
0542-7100387 76111
27
02241
76111
28
02243
29
05551
30
05905
76113
31
02228
KLINIK FAJAR
76111
32
05921
M. NURUDDIN
76252
33
02231
76111
34
06070
0542-7209414 76111
35
03271
76111
36
02245
RING-ROAD BALIKPAPAN
76111
37
06819
0542-460225
75381
0542-460148
38
03644
-0542-877330 76111
-877331
39
03711
-0541-441572 76111
-0541-422921
40
02246
RST DR HARDJANTO
76111
41
05453
0542-423409
76111
0542-415677
42
02247
76111
43
02252
OPTIK INDRA
76111
44
02248
76111
45
02249
OPTIK MEGAJAYA
46
02251
OPTIK OMEGA
47
03268
OPTIK PALAPA
48
02250
OPTIK SEMARANG
RI244010
HARI BUKA
PPK II
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/41/122012
01/01/2013
31/12/2013
12000
PER/07/062012
01/07/2012
30/06/2013
9000
PER/40/122012
01/01/2013
31/12/2013
9000
76111
PER/39/122012
01/01/2013
31/12/2013
10000
0542-7012321 76111
PER/23/092012
01/10/2012
30/09/2013
9000
PER/11/062012
01/07/2012
30/06/2013
9500
PER/13/062012
01/07/2012
30/06/2013
7000
PER101/120211
01/01/2012
31/12/2012
v
M. NURUDDIN
YAYASAN ISTIQOMAH
v
v
7000
PER/19/092012
01/10/2012
30/09/2013
14000
PER/09/062012
01/07/2012
30/06/2013
7000
PER/92/122011
01/01/2012
31/12/2012
7000
PER/30/012011
01/01/2011
31/12/2011
PER/10/082010
25/08/2010
31/07/2011
PER/97/122011
01/01/2012
31/12/2012
PER/31/012011
01/01/2011
31/12/2011
PER/94/122011
01/01/2012
31/12/2012
PER/126/122009
01/01/2010
31/12/2010
7000
PER/103/122011
01/01/2012
31/12/2012
7000
PER/88/122011
01/01/2012
31/12/2012
7000
PER/89/122011
01/01/2012
31/12/2012
7000
76111
PER/39/012011
01/01/2011
31/12/2011
7000
76111
PER/91/122011
01/01/2012
31/12/2012
7000
76111
PER/121/122009
01/01/2010
31/12/2010
7000
76111
PER/90/122011
01/01/2012
31/12/2012
7000
PKR102001
Halaman :
Tanggal :
210/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/43/032012
01/03/2012
28/02/2013
7000
PER/13/032012
01/03/2012
28/02/2013
7000
PER/46/032012
01/03/2012
28/02/2013
7000
PER/30/032012
01/03/2012
28/02/2013
7500
DR FAUZIAH ANDRIYANI
PER/18/032012
01/03/2012
28/02/2013
7000
PER/21/032012
01/03/2012
28/02/2013
7000
-085220277501 75115
DR IKA FIKRIA
PER/09/032012
01/03/2012
28/02/2013
10000
-081342411046 75243
DR M ABDUH FAISAL
PER/06/032012
01/03/2012
28/02/2013
7000
DR M SADIK
JL HIDAYATULLAH SAMARINDA
-08125539647 75115
DR M SADIK
PER/26/032012
01/03/2012
28/02/2013
7000
07883
-08125544458 75115
PER/53/052012
01/05/2012
28/02/2013
7000
11
02274
DR OSTWALD SIMATUPANG
JL PEMBANGUNAN SAMARINDA
-08164512563 75115
DR OSTWALD SIMATUPANG
PER/07/032012
01/03/2012
28/02/2013
9000
12
06519
DR RIA KOMARYAH
-0811559577
75115
DR RIA KOMARIAH
PER/31/032012
01/03/2012
28/02/2013
7100
13
04629
DR SAUT M SILITONGA
-081346620631 75243
DR SAUT M SILITONGA
PER/23/032012
01/03/2012
28/02/2013
7000
14
03743
-0811552805
75115
PER/12/032012
01/03/2012
28/02/2013
5000
15
07764
DR TEDDY ACHYAR
-081347945909 75381
DR TEDDY ACHYAR
PER/45/032012
01/03/2012
28/02/2013
7000
16
07257
-081350752337 75381
PER/11/032012
01/03/2012
28/02/2013
7000
17
06520
DR YUDITHA PATIUNG
-085250411595 75115
DR YUDHITHA PATIUNG
PER/29/032012
01/03/2012
28/02/2013
7000
18
06037
DR YUNIATI
-0852202750
75115
DR YUNIATI
PER/28/032012
01/03/2012
28/02/2013
7000
19
02263
DR. DJATMIKO
-0811598134
75132
DR. DJATMIKO
PER/19/032012
01/03/2012
28/02/2013
7000
20
02254
-0811551046
75115
PER/15/032012
01/03/2012
28/02/2013
10000
21
02262
-08164517791 75132
PER/08/032012
01/03/2012
28/02/2013
7500
22
02270
DR. MAZNIATI
-0812559201
75132
DR. MAZNIATI
PER/22/032012
01/03/2012
28/02/2013
10000
23
02269
DR. NASYAR
-081185001
75132
DR. NASYAR
PER/10/032012
01/03/2012
28/02/2013
7000
24
02253
DR. PARMONO
-0811551955
75132
DR. PARMONO
PER/20/032012
01/03/2012
28/02/2013
10500
04233
PKM SANGA-SANGA
JL SANGA-SANGA SAMARINDA
-081347945909 75243
03247
MUARA BADAK
-0811585009
75263
07765
ANGGIA MAYANGSARI
0541-738134
75115
ANGGIA MAYANGSARI
04869
-081342639933 75381
04631
DR FAUZIAH ANDRIYANI
-08137350630 75132
06521
JL. MULYO PRANOTO DESA LOH SUMBER RT 1 KEC LOA KULU -081346372451 75115
04409
DR IKA FIKRIA
04234
DR M ABDUH FAISAL
02894
10
RI244010
PKR102001
Halaman :
Tanggal :
211/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/48/042012
02/04/2012
28/02/2013
7000
PER/24/032012
01/03/2012
28/02/2013
7000
DR YOHANES
PER/17/032012
01/03/2012
28/02/2013
7000
PER/16/032012
01/03/2012
28/02/2013
7000
-08115500412 75115
PER/27/032012
01/03/2012
28/02/2013
7800
-081346628999 75115
DR.SLAMET SOEBAGIO
PER/66/072012
01/07/2012
28/02/2013
7000
-08125505305 75115
PER/67/072012
02/07/2012
28/02/2013
7000
04410
DRG ISHARYANTO
-08125324699 75243
DRG ISHARYANTO
PER/33/032012
01/03/2012
28/02/2013
8500
33
02276
DRG. ASTUTI
-0811557387
75115
DRG. ASTUTI
PER/32/032012
01/03/2012
28/02/2013
15000
34
02283
-08125861976 75571
PER/37/032012
01/03/2012
28/02/2013
9600
35
02275
DRG. BOWIE A
-081545427712 75115
DRG. BOWIE A
PER/36/032012
01/03/2012
28/02/2013
15000
36
02284
-08125861976 75243
PER/42/032012
01/03/2012
28/02/2013
7000
37
02278
DRG. DIAN S
-081520971545 75243
DRG. DIAN S
PER/35/032012
01/03/2012
28/02/2013
15000
38
02279
-08152073040 75243
PER/41/032012
01/03/2012
28/02/2013
7000
39
02281
-0811585367
75243
PER/34/032012
01/03/2012
28/02/2013
12400
40
02277
DRG. INGRAT S
-08134709295 75115
DRG. INGRAT S
PER/40/032012
01/03/2012
28/02/2013
15000
41
02285
DRG. KARMIJO
-08125857766 75115
DRG. KARMIJO
PER/39/032012
01/03/2012
28/02/2013
10000
42
02280
-0811556262
75243
PER/38/032012
01/03/2012
28/02/2013
8000
43
04590
PUSKESMAS MARANGKAYU
-085250455075 75243
HIDAYATULLAH
PER/14/032012
01/03/2012
28/02/2013
7000
44
05630
-085250455075 75115
PER/66/032008
01/02/2009
28/02/2010
45
05631
-0811585009
75115
DR W NUR AIDA
PER/53/03.2011
01/04/2011
31/03/2012
46
92289
0541-742055
75115
DR AJI SYIRAFUDDIN
PER/81/112012
01/11/2012
31/10/2013
7000
47
02289
JL DR SUTOMO
0541-761192
75115
ADJI SYARIFUDIN
PER/74/11.2008
31/10/2008
01/11/2009
70000
48
07897
0541-661015
75381
0541-661013
DR TEGUH
PER/04/022012
01/02/2012
31/01/2013
7000
49
04148
RS QURRATA A'AYUN
JL DI PANJAITAN NO 77 SAMARINDA
-0811551046
75243
DR AGUS SUKACA
PER/47/052012
01/05/2012
31/03/2013
7000
25
07815
-08125329903 75381
26
04588
-081545036800 75263
27
02259
DR. YOHANES L
-0811550240
75115
28
02268
-0811556262
75243
29
02257
30
07947
DR.SLAMET SOEBAGIO
31
07946
32
RI244010
PKR102001
Halaman :
Tanggal :
212/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
50
02287
RS. DIRGAHAYU
0541-742161
75132
DR LUKAS DEMO
51
02286
0541-741510
75243
DR ANDI MADJID
52
06804
0541-7006662 75132
0541-768755
IKA FIKRIAH
53
02297
OPTIK JAYA
0541-742731
75132
HERIYANTO JUHRIE
54
03939
0541-731069
75132
0541-731069
DR BAGYO
RI244010
HARI BUKA
PPK II
APT
v
v
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/50/072012
01/07/2012
30/06/2013
7000
PER/51/052012
01/06/2012
30/05/2013
7000
PER/71/08.2012
01/08/2012
31/07/2013
70000
PER/03/022012
01/02/2012
31/01/2013
7000
PER/01/012012
01/01/2012
31/12/2012
7000
PKR102001
Halaman :
Tanggal :
213/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/21/012012
01/02/2012
31/12/2012
1000
PER/45/112011
01/12/2011
30/11/2012
3000
PER/27/042012
01/04/2012
31/12/2012
3000
PER/34/052012
01/07/2012
30/06/2013
3000
PER/34/052012
01/07/2012
30/06/2013
3000
PER/34/052012
01/07/2012
30/06/2013
3000
PER/34/052012
01/07/2012
30/06/2013
3000
PER/34/052012
01/07/2012
30/06/2013
3000
0852-47690721 77152
PEMKAB ALINAU
PER/11/012012
01/01/2012
31/12/2012
1400
77111
NORLALILI KHAMISAH
PER/54/082012
01/09/2012
31/08/2013
5000
DR I MADE BAGIARTA
0812-5811722 77151
PER/85/122012
01/01/2013
31/12/2013
04059
0812-5878154 77151
PER/60/072012
01/07/2012
31/12/2012
13
07683
77111
PER/84/122012
01/01/2013
31/12/2013
3000
14
07043
77111
PER/88/122012
01/01/2013
31/12/2013
2950
15
06459
0812-5491185 77111
PER/89/122012
01/01/2013
31/12/2013
2500
16
02300
0811-536550
77151
PER/90/122012
01/01/2013
31/12/2013
3250
17
04791
77151
PER/91/122012
01/01/2013
31/12/2013
3495
18
04507
0553-2022220 77152
PER/09/012012
01/01/2012
31/12/2012
19
06612
0812-20404307 77111
PER/82/122012
01/01/2013
31/12/2013
20
08133
77457
PER/81/122012
01/12/2012
31/12/2013
21
07837
08-
77261
PER/28/042012
01/05/2012
30/04/2013
3000
22
05931
DR. WITOYO
77111
DR. WITOYO
PER/92/122012
01/01/2013
31/12/2013
2922
23
04057
DR.H.EDI SAMODRO.
0811-591795
77151
PER/87/122012
01/01/2013
31/12/2013
3195
24
07212
0812-54889119 77111
PER/26/032012
01/04/2012
31/03/2013
23000
07684
PKM MANSALONG I
77182
PKM MANSALONG
07658
77261
07833
PKM WONOMULYO
0812254489090
77261
PKM WONOMULYO
08039
PUSKESMAS NUNUKAN
77182
08043
PUSKESMAS PEMBELIANGAN
77182
08042
PUSKESMAS SANUR
77182
08040
77182
08041
PUSKESMAS SEIMENGGARIS
77182
07686
10
07483
11
04060
12
RI244010
2400
v
v
700
2600
2180
v
v
3000
PKR102001
Halaman :
Tanggal :
214/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/55/082012
01/09/2012
31/12/2013
5250
PER/20/012012
01/01/2012
31/12/2012
2930
PER/70/102012
01/11/2012
30/04/2013
25
07537
DRG. MARLIANI
77182
DRG. MARLIANI
26
07682
77152
27
07813
77111
28
04709
77151
29
95060
RS. TNI AL
JLN.RE.MARTADINATA TARAKAN.
77151
30
05060
0511-21353
77151
31
07685
PKM MANSALONG II
77182
32
07320
RSUD MALINAU
0553-2022220 77155
33
07538
RSUD NUNUKAN
0556-24416
77182
34
04058
RSUD TARAKAN
77151
35
07129
0551-31403
36
04803
APOTEK MARCONI
37
04759
38
07484
39
10000
70
70
v
PER/43/07/2012
01/07/2012
31/12/2012
PER/22/012012
01/02/2012
31/12/2012
3000
PER/44/072012
01/05/2012
30/04/2013
1300
PEMKAB NUNUKAN
PER/24/012012
01/09/2012
31/12/2012
5000
PEMPROV. KALTIM
PER/18/012012
01/01/2012
31/12/2012
7000
77111
PERTAMEDIKA HOSPITAL
TARAKAN
PER/19/012012
01/01/2012
31/12/2012
7000
77151
ERNA S APT
70
PULAU BUNYU
77151
DR ACHMAD ANSARI
70
77152
PER/33/082011
01/09/2011
31/08/2012
2000
07511
APOTEK KITA
77111
EKO JULIPRASETIO
PER/36/092011
01/09/2011
31/08/2012
3000
40
07163
APOTEK MARCONI
0551-35381
77111
PER/16/012012
01/01/2012
31/12/2012
41
07512
APOTEK UTAMA
77111
RUDY GUNAWAN
PER/59/082012
01/09/2012
31/12/2013
42
94801
OPTIK INTERNASIONAL
0551-25277
77151
NUR KHOLIS
43
04801
OPTIK INTERNASIONAL
77151
OPTIK INTERNASIONAL,
JARINGAN
PER/15/012012
01/01/2012
31/12/2012
44
07609
77182
LINGGARJANTO BU
PER/43/102011
01/10/2011
30/09/2012
3000
45
02308
OPTIKAL GAMA
-21924
77111
JAYADI KANDARANI
IKS/30/122009
01/01/2010
31/12/2010
7000
46
0556-24416
77182
PEMKAB NUNUKAN
PER/61/082012
01/09/2012
31/08/2013
5000
47
JL.P.IRIAN SKIP
0551-21166
77151
PEMPROV KALTIM
PER/56/082012
01/08/2012
31/08/2013
5000
RI244010
3000
70
PKR102001
Halaman :
Tanggal :
215/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
05001
75381
DR ZETH LOLONGAN
05000
PKM BENGALON
75381
DR ZETH LOLONGAN
02327
75383
RINI ALTRI
02326
05482-22644
75383
04048
75384
HARMADJI
02311
DR TETARIA ROSSI
LOK TUAN-BONTANG
75383
03682
DR YAYUK SUHARYOSO
JL MT HARYONO BONTANG
75383
04651
DR. FIRMAN
0812-53880571 75383
02313
75383
10
02309
JL.ANGKASA - BONTANG
75383
11
02310
75383
12
04503
75383
13
02314
DR. RAHMAWATI
JL. BHAYANGKARA-BONTANG
14
06871
DR. RITA
15
02315
16
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
14000
PER/22/122012
01/01/2013
31/12/2013
PER/35/122011
01/01/2012
31/12/2012
PER/21/122011
01/01/2012
31/12/2012
PER/20/122012
01/01/2013
31/12/2013
7850
PER/12/122012
01/01/2013
31/12/2013
5000
DR YAYUK
PER/16/122012
01/01/2013
31/12/2013
7000
DR. FIRMAN
PER/18/122012
01/01/2013
31/12/2013
7000
PER/13/122012
01/01/2013
31/12/2013
5000
PER/19/122012
01/01/2013
31/12/2013
7000
PER/11/122012
01/01/2013
31/12/2013
4700
PER/17/122012
01/01/2013
31/12/2013
7000
75383
PER/14/122012
01/01/2013
31/12/2013
13000
0549-2027797 75556
DR. RITA
PER/21/122012
01/01/2013
31/12/2013
6000
75383
DR SUKO RAHARDJO
PER/15/122012
01/01/2013
31/12/2013
7000
02323
0813-92679736 75383
PER/26/122012
01/01/2013
31/12/2013
30000
17
06627
DRG. ASIAH
0852-54932777 75383
DRG. ASIAH
PER/24/122012
01/01/2013
31/12/2013
12500
18
02320
75383
DRG WH AGUSTIN
PER/23/122012
01/01/2013
31/12/2013
14000
19
05466
JL YOS SUDARSO RT 18 NO 9
0549-23417
75384
DR USMAN CHUSAINI
PER/15/122011
01/07/2012
31/12/2012
11400
20
07778
0812-20058098 75383
PER/36/022012
01/03/2012
31/12/2012
14000
21
07857
0548-28839
75383
0548-24915
MISNANI,SE,M.SI
PER/37/032012
01/05/2012
31/12/2012
10000
22
04990
PKM BENGALON
75381
23
05002
75381
DR ZETH LOLONGAN
PER/IKS/PPK/I/II/PKM/02/XI
01/01/2010
I/2009
31/12/2010
24
02891
RSUD BONTANG
JL A YANI BONTANG
0548-3036990 75383
0548-3036986
PER/22/122011
01/01/2012
31/12/2012
25
02892
RSUD SANGATTA
PER/24/122011
01/01/2012
31/12/2012
75384
14000
v
v
14000
7000
RI244010
PKR102001
Halaman :
Tanggal :
216/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
26
03950
RS AMALIA BONTANG
JL DIPONEGORO NO 22 BONTANG
0548-25050
27
06066
0549-5502717 75384
28
02328
29
02329
APOTIK BONTANG
30
03946
APOTIK CARINA
31
02331
32
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
PER/23/122011
01/01/2012
31/12/2012
PER/25/122011
01/01/2012
31/12/2012
PER/IKS/PPK/II/RS/26/XII/201/01/2009
008
31/12/2009
PER/28/122011
01/01/2012
31/12/2012
PER/27/122010
01/01/2011
31/12/2011
PER/29/122011
01/01/2012
31/12/2012
75384
HARMADJI PARTODARSONO
PER/IKS/PPK/II/APT/21/XII/01/01/2010
2009
31/12/2010
75383
YUSRAN, SSI.APT
PER/27/122011
01/01/2012
31/12/2012
75383
KASMIRAN RAIS
PER/32/122011
01/01/2012
31/12/2012
OPTIK FAJAR
02334
37
02333
OPTIK OMEGA
38
05467
39
05910
40
0549-23417
PT SOHC SANGATTA
75383
YAYASAN RS PKT
75383
75383
APOTIK NI'MAH
JL ANGKASA BONTANG
75383
04049
33
02330
APOTIK YABIS
JL BHAYANGKARA BONTANG
34
04652
OPTIK BAHARI
35
03947
36
RI244010
JL.LET.JEND.S.PARMAN NO.01
75383
75383
HERIYANTO JURIE
JUMLAH
TTG
14000
14000
7000
PER/33/122011
01/01/2012
31/03/2012
v
7000
75384
HARMADJI P.DARSONO
PER/34/122011
01/01/2012
31/12/2012
2000
75383
DR INDRIATI AZIS
PER/32/122010
01/01/2011
31/12/2011
1400
445/1435/RSUD/BPPM.02 01/06/2012
31/05/2013
0548-3036990 75383
0548-3036986
PKR102001
Halaman :
Tanggal :
217/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/01/012013
09/01/2013
31/12/2013
3500
PER/34/092012
01/10/2012
30/09/2013
3500
PEMDA
PER/10/052012
01/06/2012
31/05/2013
PER/37/122012
01/10/2012
30/09/2013
7000
0852-46637170 77272
PER/14/032011
01/09/2011
31/08/2012
0812-5822754 77272
DR ADNAN
PER/23/072012
01/08/2012
31/07/2013
7000
DR ALEX P SIDABUTAR
-081347147164 77352
DR ALEX P SIDABUTAR
PER/05/022012
01/03/2012
28/02/2013
7000
02882
-0554-24724
77371
PER/27/082012
01/09/2012
31/08/2013
7000
04730
-08115401454 77352
DR DESSERY RANDANAN
PAKIDING
10
94804
DR EMI RASMIYANTI
-081347830353 77352
DR EMI RASMIYANTI
PER/36/122012
01/02/2013
31/12/2013
2000
11
02881
DR MATHEUS M POPANG
-0811594589
77371
PER/20/072012
01/08/2012
31/07/2013
7000
12
04989
-085216433033 77352
PER/03/012012
01/01/2012
31/12/2012
13
07168
0552-2026839 77271
0811-536472
PER/30/082012
01/09/2012
31/08/2013
7000
14
06426
DR. WIWIN
0813-47264306 77381
PER/35/112012
01/01/2013
31/12/2013
7000
15
94806
77352
PER/17/062012
01/07/2012
30/06/2013
7500
16
07874
77352
PER/21/072012
01/08/2012
31/07/2013
5000
17
07158
0552-2026839 77262
PER/29/082012
01/09/2012
31/08/2013
7000
18
07108
DRG SUKMA
0813-42002900 77272
DRG SUKMA
PER/25/072012
01/08/2012
31/07/2013
7000
19
95861
-08123490442 77371
PER/07/032012
01/04/2012
30/03/2013
7500
20
05846
KLINIK PRIMA
-08152115137 77352
DR. MUJAHIDAH
PER/28/082012
01/09/2012
31/08/2013
7000
21
02884
0554-21098
77371
PEMDA
22
07059
0552-21292
77271
0552-22667
23
04731
APOTEK SANGKAKALA
77352
LILY YULIANA
24
05865
-08155223355 77352
LILY YULIANA
08174
08028
PUSKESMAS LABANAN
77352
SUPARNO
04468
77352
07176
07169
07106
DR ADNAN
07757
RI244010
-081346221954 77313
7000
7000
PER/18/042012
01/08/2012
31/07/2014
7000
PER/01/012012
01/01/2012
31/12/2012
10000
PER/23/082011
01/09/2011
31/08/2012
7000
PER/24/092011
01/09/2011
31/08/2012
v
v
PKR102001
Halaman :
Tanggal :
218/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
04493
-043821264
07671
95782
06895
PUSKESMAS BAHU
96251
06830
PUSKESMAS WOLAANG
96251
02409
JL SAMRATULANGI MANADO
96251
06744
0430-22715
96251
04077
BP IMMANUEL
JL SAM RATULANGI NO 18
-844866
96251
02397
DR A ANTHARI
07552
DR DEEVYPELEALU,M.BIOMED,DK
10
02406
DR ELLEN WUISAN
11
02402
12
HARI BUKA
PPK II
S
RS
APT
PER/42/062012
01/03/2012
28/02/2013
9000
PER/02/012012
01/01/2012
28/02/2013
7000
NO IKS
JUMLAH
TTG
v
DR MARYANI SURONOTO
POLA PEMBIAYAAN
JAM BUKA
PER/58/102012
01/10/2012
28/02/2013
9000
PER/64/112012
01/12/2011
28/02/2013
7000
PER/18/032012
01/03/2012
28/02/2013
15000
PER/44/052012
01/06/2012
28/02/2013
7000
PER/17/032012
01/03/2012
28/02/2013
10000
96251
PER/21/032012
01/03/2012
28/02/2013
7000
96251
PER/59/112012
01/11/2012
28/02/2013
7000
96251
PER/30/032012
01/03/2012
28/02/2013
7000
DR FRANS P
KOTAMOBAGU MANADO
93561
PER/13/032012
01/03/2012
28/02/2013
7000
02392
DR G TANGKILISAN
JL TNI IV NO 7 MANADO
96251
PER/11/032012
01/03/2012
28/02/2013
7000
13
02932
BITUNG
96251
DR HEIN MONINGKA
01/03/2012
28/02/2013
7000
14
07259
DR HENRY TUMBOIMBELA
0438-38600
96251
DR HENRY TUMBOIMBELA
PER/48/042012
01/04/2012
28/02/2013
15
07260
0438-43851159 96251
PER/49/042012-KAPITASI 01/07/2012
28/02/2013
16
04277
DR JANNE HAMPP
90661
PER/09/032012
01/03/2012
28/02/2013
17
04654
DR JEFRIE N. SUMAYKU
-043837860
96251
PER/12/032012
01/03/2012
28/02/2013
7000
18
02403
DR JIMMY POSANGI
96251
PER/26/032012
01/03/2012
28/02/2013
7000
19
02393
DR M RUMAMBI
96263
PER/28/032012
01/03/2012
28/02/2013
7000
20
04278
DR MARYANI SURONOTO
96263
PER/25/032012
01/03/2012
28/02/2013
7000
21
07075
DR SAHARA ALBUGIS
96251
PER/01/022011
01/02/2011
31/01/2012
22
02407
DR SINOLUNGAN
JL SAMRATULANGI MANADO
96251
PER/10/032012
01/03/2012
28/02/2013
7000
23
02391
DR SRI SOEBEKTI
JL BETHESDA MANADO
96251
PER/34/032012
01/03/2012
28/02/2013
7000
24
06186
DR STELLA SAFITRI
96251
PER/40/052012
01/05/2012
28/02/2013
7000
RI244010
DR VIRGINIA MV WINDAH
v
KAPTEN STEFANUS TULUMANG
DR DEEVY PELEALU
DR SAHARA ALBUGIS
7000
7000
v
v
7000
7000
PKR102001
Halaman :
Tanggal :
219/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
25
07760
DR STONE E KAKAMBONG
26
06315
27
06226
28
96251
96251
DR VIRGINIA M V W M KES
96251
05194
96251
29
06743
90951
30
05151
96251
31
05530
JL JHONI SUHODO NO 03
32
07076
33
07396
34
07535
35
DR STONE E KAKAMBONG
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/45/092012
01/09/2012
28/02/2013
PER/46/102012
01/10/2012
28/02/2013
PER/51/102012
01/10/2012
28/02/2013
DR SM MAYA WANGET
PER/14/032012
01/03/2012
28/02/2013
PER/50/102012
01/10/2012
28/02/2013
93561
PER/06/032012
01/03/2012
28/02/2013
7000
96251
PER/03/022012
01/02/2012
28/02/2013
7000
0813-56565155 96251
PER/55/072012
01/07/2012
28/02/2013
7000
96251
PER/57/102012
01/07/2012
28/02/2013
14000
05382
JL. 14 FEBRUARI
96251
PER/66/112012
01/02/2012
28/02/2013
20000
36
03825
96251
PER/32/032012
01/03/2012
28/02/2013
15000
37
07078
RB INDE DOU
96251
PER/05/032012
01/03/2012
28/02/2013
7000
38
02410
JL 14 FEBRUARI TELING
96251
DR JEANETTE SIBY
PER/35/032012
01/03/2012
28/02/2013
7000
39
07395
SHERLY F NAYOAN
0852-41714966 96251
SHERLY F NAYOAN
PER/54/072012
01/07/2012
28/02/2013
7000
40
02400
PUSKESMAS LIKUPANG
LIKUPANG MANADO
95375
PER/38/032012
01/03/2012
28/02/2013
7000
41
02936
RS TELING
96251
PER/23/032012
01/03/2012
28/02/2013
15000
42
03278
RUMKITAL
96251
PER/42/092011
01/09/2011
28/02/2013
7000
43
02411
96251
PER/33/032012
01/03/2012
28/02/2013
7000
44
07336
RSUD BITUNG
0438-38066
96251
0438-38066
PEMERINTAH
PER/53/062012
01/06/2012
28/02/2013
20000
45
07669
95781
DR MARYANI SURONOTO
PER/64/122011
01/01/2012
28/02/2013
46
07261
0431-879475
96251
PER/47/042012
01/04/2012
28/02/2013
7000
47
02412
96251
PER/31/032012
01/03/2012
28/02/2013
7000
48
04078
RS BUDI SETIA
90552
PER/29/032012
01/03/2012
28/02/2013
7000
49
02939
RS KINAPIT
93652
PER/07/032012
01/03/2012
28/02/2013
10000
50
02937
RS SITI MARYAM
JL POGIDON NO 110
96251
PER/36/032012
01/03/2012
28/02/2013
7000
51
06149
JL RAYA TOMOHON
96263
PER/39/032012
01/02/2012
28/03/2012
10000
RI244010
PER/62/2012
01/03/2012
28/02/2013
7000
v
v
4000
7000
v
v
7000
7000
PKR102001
Halaman :
Tanggal :
220/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
52
07077
53
03279
RS PROF RATUMBUYSANG
MANADO
54
02414
JL RAYA TANAWANGKO
96251
55
07670
95782
NURAENY WAHAB
56
07553
APOTEK UNO
0431-868933
96251
DR EDDY KARUNDENG
57
02940
APOTIK KOTAMOBAGU
KOTAMOBAGU
93652
58
06279
APOTIK RAKYAT
96251
TJANDRA SUBRATA
59
07490
OPTIK ANEKA
96251
RINTO TERTAMULIA
60
02415
OPTIK HARMONIS
JL SAMRATULANGI SULUT
96251
61
05066
OPTIK INTERNATIONAL
62
02934
OPTIK MURNI
63
05381
OPTIK RAME
JL RAYA TOMOHON NO 18
64
02935
65
07557
66
04283
LABORATORIUM MEDYLAB
RI244010
96251
DR B GUNADY, SP.OG
HARI BUKA
PPK II
OPT LAB PEM ABRI BUMN SWASTA
POLA PEMBIAYAAN
JAM BUKA
NO IKS
PER/04/022012
JUMLAH
TTG
28/02/2013
7000
1
7000
PER/37/032012
01/03/2012
28/02/2013
PER/01/012012
01/01/2012
28/02/2013
PER/61/112012
01/11/2012
28/02/2013
PER/08/032012
01/03/2012
28/02/2013
PER/52/072012
01/07/2012
28/02/2013
PER/56/092012
01/09/2012
28/02/2013
5000
PER/20/032012
01/03/2012
28/02/2013
7000
96251
PER/43/062012
01/07/2012
28/02/2013
7000
96251
PER/27/032012
01/03/2012
28/02/2013
7000
96263
PER/16/032012
01/02/2012
28/02/2013
200000
96251
PER/19/032012
01/03/2012
28/02/2013
7000
0431-3325043 96251
PER/60/112012
01/11/2012
28/02/2013
7000
JL RAYA TANAWANGKO
96251
PER/22/032012
01/03/2012
28/02/2013
7000
7000
PKR102001
Halaman :
Tanggal :
221/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/10/122011
01/01/2012
31/12/2012
7000
PER/19/122011
01/01/2012
31/12/2012
7000
PER/13/052012
01/06/2012
31/05/2013
7000
PER/26/062011
01/06/2011
31/05/2012
7000
PER/10/052012
01/06/2012
31/12/2013
12000
PER/12/052012
01/06/2012
31/05/2013
7000
93761
PER/15/122011
01/01/2012
31/12/2012
7000
93662
PER/07/012011
01/01/2011
31/12/2011
7000
94683
PER/03/032012
01/03/2012
28/02/2013
7000
PUSKESMAS BATUI
93781
PER/84/122012
01/01/2013
31/12/2013
7000
05354
PUSKESMAS KAMONJI
0451-458307
95856
PER/87/122012
01/01/2013
31/12/2013
7000
12
02460
94714
PER/89/122012
01/01/2013
31/12/2013
7000
13
05133
0453-23736
93662
PER/16/122011
01/01/2012
31/12/2012
14
06767
PUSKESMAS MABELOPURA
0451-484466
95862
PER/98/122012
01/01/2013
31/12/2013
7000
15
02458
PUSKESMAS MAMBORO
95858
PER/83/122012
01/01/2013
31/12/2013
7000
16
92459
PUSKESMAS PANTOLOAN
PANTOLOAN PALU
95856
PER/81/122012
01/01/2013
31/12/2013
17
04701
PUSKESMAS PARIGI
PER/85/122012
01/01/2013
31/12/2013
18
02457
PUSKESMAS SINGGANI
95858
PER/82/122012
01/01/2013
31/12/2013
19
03741
PUSKESMAS TOILI II
93794
PER/88/122012
01/01/2013
31/12/2013
7000
20
04702
PUSKESMAS TORUE
PER/86/122012
01/01/2013
31/12/2013
7000
21
08077
94111
PER/67/102012
01/10/2012
31/12/2012
7000
22
08009
0813-18941060 94231
DRG. LUTFIAH
PER/19/082012
01/08/2012
31/12/2012
7000
23
07393
JL DR SUHARSO NO 29 PALU
0451-457604
95858
24
08078
94111
25
07832
0461-22660
93662
26
06582
JL KARTINI NO 20 PALU
95858
05404
JL LANONI NO.37
0453-21300
95883
04347
JL THALUAKOJI NO 11 PALU
0451-491470
95856
0451-491605
05353
JL KANGKUNG NO 1 PALU
0451-460570
95856
06769
91353
04985
94113
02465
JL DR SUHARSO PALU
95856
02907
04673
PUKESMAS BUNTA
07829
10
02461
11
DRG HARTINI
7000
7000
7000
v
v
7000
PER/15/052012
01/06/2012
31/05/2013
7000
PER/68/102012
01/10/2012
31/12/2012
7000
PER/01/032012
01/01/2012
31/12/2012
14000
PER/14/122011
01/01/2012
31/12/2012
RI244010
PKR102001
Halaman :
Tanggal :
222/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
27
07166
93662
28
04327
RSJ MADANI
JL THALUAKOJI NO 11 PALU
0451-491470
95856
0451-491605
29
05003
RSU ANUTAPURA
95856
30
05134
RSU MOKOPIDO
0453-21300
95883
31
03444
RSU UNDATA
JL DR SUHARSO PALU
32
04984
RSUD ANUNTALOKO
33
03445
RSUD LUWUK
34
06767
35
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
31/12/2012
14000
12000
PER/04/122011
PER/09/122011
01/01/2012
31/12/2012
PER/13/052012
01/06/2012
31/05/2013
PER/10/122011
01/01/2012
31/12/2012
14000
95856
PER/12/052012
01/06/2012
31/05/2013
7000
0450-21032
94111
PER/10/052012
01/06/2012
31/12/2013
12000
0461-21820
93662
PER/15/122011
01/01/2012
31/12/2012
7000
RSUD POSO
JL SUDIRMAN NO 33 POSO
0452-21771
91252
0452-324360
PER/26/062011
01/06/2011
31/05/2012
12000
02467
JL DR SUHARSO PALU
0451-424923
95862
PER/93/122012
01/01/2013
31/12/2013
7000
36
02468
JL IMAM BONJOL
93662
PER/27/192007
23/09/2007
22/09/2009
7000
37
07831
APOTEK JAKARTA
94683
38
07503
JL LANONI NO 37 TOLITOLI
95691
39
07502
40
07504
JL KANGKUNG NO 1 PALU
41
07501
42
07505
43
v
v
PER/05/032012
01/03/2012
28/02/2013
PER/13/122011
01/01/2012
31/12/2012
95856
PER/13/122011
01/01/2012
31/12/2012
95856
PER/13/122011
01/01/2012
31/12/2012
93662
PER/13/122011
01/01/2012
31/12/2012
91252
PER/13/122011
01/01/2012
31/12/2012
08111
0451-491869
94111
FIRMAN TONAPA
PER/78/112012
01/11/2012
31/12/2013
14000
44
04986
93662
GAZALI SYAFEI
PER/09/052012
01/06/2012
31/05/2013
7000
45
03231
OPTIK CERIA
JL PATTIMURA PALU
0411-458839
95856
PER/94/122012
01/01/2013
31/12/2013
7000
46
03232
0451-455124
95856
PER/12/122011
01/01/2012
31/12/2012
7000
RI244010
DR NIKO
PKR102001
Halaman :
Tanggal :
223/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
07079
0442-310020
93461
0442-830010
07727
PKM KABILA
93351
PKM KABILA
07724
93351
07725
93351
07726
PKM TOMBULILATO
93351
03833
DR HERNI A PAKAYA
0435-831758
96125
06609
04533
DR SUNARTI TUAH
0435-827223
04835
10
04886
11
06101
12
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/12/032012
01/03/2012
31/12/2012
8000
PER/01/012012
01/02/2012
31/01/2013
4000
PER/01/012012
01/02/2012
31/01/2013
4000
PER/01/012012
01/02/2012
31/01/2013
4000
PKM TOMBULILATO
PER/01/012012
01/02/2012
31/01/2013
4000
DR HERNI A PAKAYA
PER/03/012013
01/01/2013
31/12/2013
5000
93351
PER/07/012013
01/01/2013
31/12/2013
3500
93351
0435-827223
DR SUNARTI TUAH
PER/01/012013
01/01/2013
31/12/2013
7000
08124-4815222 93351
DR.ARIFIN ABUBAKAR
PER/13/012013
01/01/2013
31/12/2013
4000
93351
PER/02/012013
01/01/2013
31/12/2013
4000
93351
PER/06/012013
01/01/2013
31/12/2013
7000
04534
0435-827223
93351
0435-827223
PER/04/012013
01/01/2013
31/12/2013
11000
13
05073
93461
PER/05/012013
01/01/2013
31/12/2013
8000
14
06616
93351
PER/11/012013
01/01/2013
31/12/2013
8000
15
07585
93351
PER/12/012013
01/01/2013
31/12/2013
8000
16
02388
JL SULTAN BOTUTIHE
0435-821217
93351
0435-821217
PER/02/042012
01/03/2012
31/12/2012
11000
17
07887
96582
PER/03/052012
01/03/2012
31/12/2012
11000
18
06102
93354
PER/14/072012
01/06/2012
31/12/2012
11000
19
06104
0435-821683
93351
PER/06/042012
01/04/2012
31/12/2012
11000
20
03834
0435-827223
93351
PER/10/012013
01/01/2013
31/12/2013
11000
21
06207
93354
PER/14/072012
01/06/2012
31/12/2012
11000
22
06415
APOTEK MOTILANGO
0435-830198
93351
APOTEK MOTILANGO
PER/16/092011
01/10/2011
30/09/2012
23
03750
24
04789
OPTIK CERIA
0435-824001
93351
OPTIK CERIA
PER/09/012013
01/12/2012
31/12/2013
11000
25
06610
OPTIK METRO
0435-830196
93351
OPTIK METRO
PER/08/012013
01/01/2013
31/12/2013
7000
26
07584
LABORATORIUM PRODIA
0435-826246
93351
0435-824676
LABORATORIUM PRODIA
PER/03/042012
01/04/2012
31/12/2012
15000
RI244010
v
v
v
v
7000
PKR102001
Halaman :
Tanggal :
224/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
07416
BP BHAYANGKARA POLMAN
JL. DR RATULANGI NO 17
98854
07103
KLINIK BKKM-DINKES
0411-879257
90222
0411-877398
07533
92176
04766
90111
07194
93353
07322
PPK I GIGI - RSUD LAMMADUKELLENG WAJO JL KARTIKA CHANDRA KIRANA KABUPATEN WAJO
98451
05417
PUSKESMAS ANTANG
0411-492752
90231
0411-492490
02920
PUSKESMAS BALOCCI
90231
02915
PUSKESMAS BIRA
JL IR SUTAMI NO 128
90231
10
02357
PUSKESMAS BUNGORO
11
02359
PUSKESMAS KALABBIRANG
12
03738
13
HARI BUKA
PPK II
S
RS
APT
NO IKS
PER/024/012013
01/01/2013
31/12/2013
PER/07/012013
01/01/2013
31/12/2013
01/08/2012
30/06/2013
JUMLAH
TTG
POLA PEMBIAYAAN
JAM BUKA
7000
7000
v
v
7000
10000
v
v
PER/003/012012
01/01/2012
31/12/2012
7000
PER/019/042012
01/04/2012
31/12/2012
7000
PER/012/012013
01/01/2013
31/12/2013
MANSUR TP SKM
PER/035/072012
01/07/2012
30/06/2013
PER/13/012013
01/01/2013
31/12/2013
7000
90231
PER/081/102012
SENIN, SELASA, RABU, UMUM (SHIFT 1), GIGI
(SHIFT PAGI), SALIN (SHIFT
KAMIS, JUM'AT,
24JM)
SABTU
01/11/2012
31/12/2013
7000
0410-2315652 98352
PER/083/102012
01/11/2012
31/12/2013
7000
PUSKESMAS MANDAI
MANDAI MAROS
90000
DRG MARYUNIATI
PER/004/012012
01/01/2012
31/12/2012
7000
02360
PUSKESMAS MINASATENE
98352
DR H NAJAMUDDIN PALANCOI
MARS
PER/084/102012
01/11/2012
31/12/2013
7000
14
02358
PUSKESMAS TARAWEANG
90111
DR H MUH GISMAN
PER/082/102012
01/11/2012
31/12/2013
7000
15
03739
JL ABDULLAH DG SIRUA LR 6 NO 3
0411-443718
90231
PER/023/012013
01/01/2013
31/12/2013
7000
16
06787
DR ALIAWATI ALBEK
08565-6315302 92652
PER/051/082012
01/08/2012
30/06/2013
7000
17
07520
DR AMIS RIFAI
98361
PER/04/012013
01/01/2013
31/12/2013
7000
18
03968
JL AIRPORT HASANUDDIN NO 3
0411-4813247 90231
PER/086/102012
01/11/2012
31/12/2013
5000
19
06228
DR H AHMADY, M.KES
93353
DR H AHMADY, M.KES
PER/047/082012
01/08/2012
30/06/2013
7000
20
04765
DR H HAZNAM KAHARUDIN
0811-445444
90231
DR H HAZNAM KAHARUDIN
PER/05/012013
01/01/2013
31/12/2013
7000
21
04306
JL LAHALEDE NO 93 PAREPARE
90231
PER/090/2012
01/11/2012
31/12/2013
3500
22
05034
DR HELMY JUSUF
0411-550228
90231
DR HELMY JUSUF
PER/059/092012
01/09/2012
30/06/2013
7000
23
07197
-085342023023 98453
PER/025/012013
01/01/2013
31/12/2013
7000
24
07534
DR M AKBAR PRIYONO
92411
PER/064/102012
01/10/2012
31/12/2013
7000
RI244010
7000
v
v
7000
PKR102001
Halaman :
Tanggal :
225/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
SABTU
25
04762
0812-4180194 90231
26
07193
-081355503377 98451
27
07770
DR RAHMI RIANI
0852-42036571 98653
28
06797
DR SUKMAWATI ABDUH
0419-21335
82361
29
07264
DR SUKMAWATY(HERONA)
JL SILIWANGI NO 27 PARE-PARE
0813-42728571 91122
30
05346
DR SURIANI ALIMUDDIN
0811-462674
9000
31
02339
0411-880664
90231
32
07521
DRG M SABIRUDDIN
98361
33
06792
JL ANGGREK NO 11 BONTOSUNGGU
82361
34
06106
0411-433334
90231
35
05196
36
06758
37
04308
38
06790
39
7000
PER/063/102012
01/10/2012
31/12/2013
PER/026/012013
01/01/2013
31/12/2013
DR RAHMI RIANI
PER/014/012013
01/01/2013
31/12/2013
DR SUKMAWATI ABDUH
PER/015/012013
01/01/2013
31/12/2013
PER/01/012013
01/01/2013
31/12/2013
7000
DR SURIANI ALIMUDDIN
PER/06/012013
01/01/2013
31/12/2013
7000
PER/065/102012
01/10/2012
30/09/2013
7000
PER/013/032012
01/03/2012
31/12/2012
7000
PER/049/082012
01/08/2012
30/06/2013
7000
PER/036/072012
01/07/2012
30/06/2013
7000
90231
PER/037/072012
01/07/2012
30/06/2013
7000
98653
PER/038/072012
01/07/2012
30/06/2013
7000
90231
PER/060/092012
01/09/2012
30/06/2013
7000
JL TERATAI NO 9
92552
PER/045/082012
01/08/2012
30/06/2013
7000
06596
92716
PER/027/012013
01/01/2013
31/12/2013
7000
40
04748
DRG MARYUNIATI
0815-24163609 90231
DRG MARYUNIATI
PER/092/102012
01/11/2012
31/12/2013
41
06789
92652
PER/052/082012
01/08/2012
30/06/2013
7000
42
07323
DRG NIRWANA AS
98453
DRG NIRWANA
PER/028/012013
01/01/2013
31/12/2013
7000
43
03385
90231
PER/095/112012
01/12/2012
31/12/2013
7500
44
04900
90231
PER/094/112012
01/12/2012
31/12/2013
7000
45
07472
90111
PER/047/082012
01/08/2012
31/12/2012
46
06611
0411-581983
90111
PER/039/072012
01/07/2012
30/06/2013
7000
47
06107
0411-881505
90114
0411-881505
01/01/2013
31/12/2013
7000
01/11/2012
31/12/2013
10000
RI244010
PER/085/102012
v
v
7000
5000
v
v
7000
14000
3500
PKR102001
Halaman :
Tanggal :
226/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
48
02913
KLINIK ALIYYAH
JL CUMI-CUMI NO 26
0411-452049
90231
49
06635
KLINIK GRANIYA
0411-590696
90111
DR HAMRI
50
04249
90231
51
02912
KLINIK MALLIHAH
JL KUMALA NO 99
0411-862585
90231
52
04411
KLINIK MAPPANYUKKI
0411-8111773 90231
53
06452
0418-324387
92211
54
07808
KLINIK PAJJAIANG
90111
55
06419
98252
56
04095
KLINIK SASQIA
JL ANUANG NO 181
0411-877320
90231
57
07678
0411-2940091 90111
58
04906
KLINIK SOPHIARA
JL ANTANG RAYA NO 49 F
0411-490181
59
02335
60
02336
61
HARI BUKA
PPK II
S
RS
APT
DR A AMAL MAKMUR
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
KAMIS, JUM'AT,
SABTU
PER/046/082012
01/08/2012
30/06/2013
7000
PER/087/102012
01/11/2012
31/12/2013
7000
PER/040/072012
01/07/2012
30/06/2013
7000
PER/03/012013
01/01/2013
31/12/2013
10000
DR HJ NORMAWATY
MANSYUR,M.KES
PER/08/012013
01/01/2013
31/12/2013
7000
RUSMAN,S.SI.APT
PER/09/012013
01/01/2013
31/12/2013
5000
PER/016/012013
01/01/2013
31/12/2013
2500
PER/10/012013
01/01/2013
31/12/2013
7000
PER/041/072012
SENIN, SELASA, RABU, UMUM (SHIFT
MALAM,SHIFT SIANG), GIGI
KAMIS, JUM'AT,
(SHIFT SORE)
SABTU
01/07/2012
30/06/2013
7000
90231
01/01/2013
31/12/2013
JL BARUKANG N0 31
0411-4666508 90231
DR H A BASO SULAIMAN
PER/079/102012
01/11/2012
31/12/2013
7000
90231
DR H A BASO SULAIMAN
PER/080/102012
01/11/2012
31/12/2013
5300
07471
90111
PER/042/072012
01/07/2012
30/06/2013
5000
62
06165
0428-22345
98854
0428-22345
DR ANAS BUDI
PER/053/082012
01/08/2012
31/12/2012
63
02342
JL ST ALAUDDIN NO 110
0411-868920
90231
PER/091/102012
01/11/2012
31/12/2013
10000
64
06171
90111
PROF DR SABBELE
PER/11/012013
01/01/2013
31/12/2013
7000
65
04763
JL SRIKAYA BULUKUMBA
90111
66
06746
RS DR M YASIN BONE
0481-21082
92716
67
04700
JL NURUSSAMAWATI PAREPARE
0421-21163
91122
0421-24330
68
03503
JL DG NGEPPE NO 14 MAKASSAR
90111
69
07192
-081342282169 92652
70
93501
JL DR RATULANGI NO 81
0411-872120
90231
0411-830454
71
03501
JL DR RATULANGI NO 81
0411-872120
90231
72
07196
RSUD LAMADDUKKELLENG
-081282509256 98451
73
06786
0419-21084
RI244010
82361
v
v
7000
500
7000
7000
PER/043/072012
01/07/2012
30/06/2013
PER/077/102012
01/11/2012
31/12/2012
PER/078/102012
01/11/2012
31/12/2013
PER/093/112012
01/11/2012
31/12/2013
PER/044/072012
01/07/2012
30/06/2013
97/PKS/112007
01/07/2007
30/06/2008
PEMKAB WAJO
PER/019/042012
01/04/2012
31/12/2012
7000
PER/055/082012
01/08/2012
30/06/2013
10000
7000
PKR102001
Halaman :
Tanggal :
227/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
74
04676
90111
75
94676
90111
76
07104
93353
77
03502
RSUD PANGKEP
0410-2311118 90231
78
94767
0481-21069
90111
DR HJ A KHASMA MKES
79
94901
RSUP DAYA
JL PERINTIS KEMERDEKAAN
0411-510016
90111
DR HJ ST SAENAB NB MKES
80
04413
0411-8111773 90231
DR TAUFIQQULHIDAYAT ANDE
81
04749
RS IBNU SINA
0411-452917
90111
82
94749
RS IBNU SINA
0411-452917
90231
83
07195
0411-871942
90222
84
05478
JL R A KARTINI NO 15-17
0411-324554
90231
85
04764
RSUD BULUKUMBA
JL SRIKAYA BULUKUMBA
90111
86
02349
JL DR RATULANGI NO 81
0411-855875
90231
0411-859125
87
02352
JL DG NGEPPE NO 14
0411-855934
90231
RSUD HAJI
88
04412
JL ANDI MAPPANYUKKI NO 14
0411-8111773 90231
0411-443181
DR TAUFIQQULHIDAYAT ANDE
89
07951
90111
90
07677
92411
91
07885
0411-4662423 90111
92
07470
JL YOS SUDARSO
93
06843
OPTIK HOKKY
94
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/033/062012
01/06/2012
31/12/2012
PER/03/012012
01/01/2012
31/12/2012
PER/069/102012
01/10/2012
31/12/2013
10000
14000
PER/32/06/2012
01/06/2012
31/12/2012
PER/70/102012
01/10/2012
31/12/2013
15000
PER/015/032012
01/03/2012
31/12/2012
7000
PER/058/092012
01/09/2012
31/08/2013
10000
7000
PER/018/012013
01/01/2013
31/12/2013
PER/075/102011
01/10/2011
30/09/2012
PER/108/102011
01/10/2011
30/09/2012
PER/030/062012
01/06/2012
31/05/2013
PER/006/012012
01/01/2012
31/12/2012
7000
0411-425502
PER/020/012013
01/01/2013
31/12/2013
10000
90111
RICHARD SITUJU, ST
PER/054/082012
01/08/2012
30/06/2013
90111
KIKI MEIVIRA
PER/057/082012
01/09/2012
30/06/2013
7000
0411-445224
90111
NY ASRI TAYANG SE
v
v
95
06842
OPTIK OMEGA
90111
KIKI MEIVIRA
PER/056/082012
01/09/2012
30/06/2013
7000
96
02355
OPTIK SURYA
90115
HARYAN CHANDRA
PER/028/052012
01/05/2012
31/12/2012
7000
RI244010
PKR102001
Halaman :
Tanggal :
228/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
01/12/2012
31/12/2013
70000
01/05/2012
22/09/2012
7000
01/12/2012
31/12/2013
7000
01/11/2012
31/12/2013
7000
01/05/2012
30/04/2013
01/12/2012
31/12/2013
99356
01/07/2012
31/12/2013
15000
97753
PER / 40 / 12012
01/05/2012
31/12/2012
15000
0401-321733
99356
01/07/2012
31/12/2013
15000
JL DR SUTOMO NO 1 KOLAKA
98152
01/05/2012
31/12/2013
15000
07973
99356
SENIN, SELASA, RABU, UMUM (SHIFT PAGI), GIGI PER / 012 / 072012
(SHIFT PAGI), SALIN (SHIFT
KAMIS, JUM'AT,
PAGI)
SABTU, MINGG
01/08/2012
31/01/2013
5000
12
03127
PUSKESMAS TAMPO
97853
PER/ 019/052009
01/05/2009
30/04/2010
7000
13
05014
PUSKESMAS TOMIA
97753
WA ODE SAMUMI
01/09/2009
31/08/2010
5000
14
05874
DR ALGAZALI
0813-41779496 99356
DR ALGAZALI
01/07/2012
30/06/2013
7000
15
03749
DR DIDIN ROHIDIN
0811-403974
99356
DR DIDIN ROHIDIN
01/12/2012
31/12/2013
7000
16
02376
97853
DR. HJ WD ASWATI
01/12/2011
30/11/2012
5000
17
08086
DR MULYANTI SULASTRI
JL SULTAN HASANUDDIN NO 2
93711
DR MULYANTI SULASTRI
01/11/2012
30/04/2013
2000
18
06524
JL REPELITA NO 81
0405-2321375 98152
DR ANDI TENRY
PER/001/012012
01/12/2011
30/11/2012
7000
19
06685
DR. KAMARULLAH
0812-4175062 98152
DR KAMARULLAH
01/06/2012
30/11/2012
7000
20
06392
JL DIPONEGORO NO 05
0811-4105709 99665
01/11/2012
31/12/2013
21
06717
RS ANTAM POMALAA
0405-2310400 99563
01/07/2012
30/06/2013
15000
22
05376
0401-393670
99356
01/12/2012
31/12/2013
15000
23
05638
0402-2822829 97753
01/12/2012
31/12/2013
24
07915
93885
17/05/2012
30/04/2013
7000
25
07974
99553
01/08/2012
31/01/2013
7000
04565
0401-3128196 99655
07563
PKM LAINEA
93881
03710
PKM POASIA
0401-3193670 99356
02383
JL POMALAA KOLAKA
99356
07900
PKM TINANGGEA
93885
04219
PKM WAJO
0402-2822829 97753
02929
02378
02379
10
04512
11
7000
7000
7500
RI244010
PKR102001
Halaman :
Tanggal :
229/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
26
05377
0402-2825353 93711
27
05378
0401-3121694 99356
28
05379
29
05380
RSUD KOLAKA
JL DR SUTOMO NO 1 KOLAKA
0405-21042
30
02382
0401-3122070 99356
31
08027
OPTIK CERIA
JL SYECH YUSUF NO 40
99562
JUNAIDI TENG
32
02930
OPTIK KENDARI
0401-322224
99356
RI244010
HARI BUKA
PPK II
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/031/122011
01/12/2011
30/11/2012
01/12/2011
30/11/2012
15000
01/06/2012
31/12/2013
15000
01/12/2011
30/11/2012
15000
01/12/2011
30/11/2012
15000
01/09/2012
31/12/2013
4000
01/01/2012
31/12/2012
15000
0401-3121733 99356
98152
0401-3122070
PKR102001
Halaman :
Tanggal :
230/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
04896
PKM WOWONDULA
94782
DR.APRIL KAPUS
06301
PUSKESMAS ANGKONA
94665
PUSKESMAS ANGKONA
01/05/2012
30/04/2013
7000
06350
PUSKESMAS BELOPA
94652
PUSKESMAS BELOPA
PER/42/102012
01/10/2012
30/09/2013
3000
04009
PUSKESMAS BUA
94761
PER/02/022012
01/03/2012
28/02/2013
06300
PUSKESMAS BURAU
94665
PUSKESMAS BURAU
PER/18/042012
01/04/2012
31/03/2013
7000
02370
PUSKESMAS GETENGAN
MAKALE PALOPO
91831
PER/23/062012
01/06/2012
31/05/2013
7000
06305
PUSKESMAS KALAENAKIRI
94665
PUSKESMAS KALAENAKIRI
PER/20/052012
01/05/2012
30/04/2013
7000
06302
PUSKESMAS LAMPIA
94665
PUSKESMAS LAMPIA
PER/32/042012
01/04/2012
31/03/2013
7000
03131
PUSKESMAS MALILI
MALILI
94665
PUSKESMAS MALILI
PER/15/012012
01/01/2012
31/12/2012
7000
10
04732
PUSKESMAS MASAMBA
94782
PUSKESMAS MASAMBA
11
07353
PUSKESMAS RANTEPAO
0423-21797
91831
PUSKESMAS RANTEPAO
12
04010
PUSKESMAS WARA
21912
PUSKESMAS WARA
13
07882
DR ANNA TODING
JL HASANUDDIN F NO 2 SOROAKO
085-242351130 92971
DR ANNA TODING
14
05923
DR ARIDA
91831
DR ARIDA
15
06875
DR BIDASARI JUMIE
08124-2893914 91913
DR BIDASARI JUMIE
16
06250
DR H RUSDI
0821-88179494 91913
DR H RUSDI
17
05407
DR HENNY
-0811422065
91831
DR HENNY
18
05863
DR HJ ERNAWATI ABDULLAH
94782
DR HJ ERNAWATI ABDULLAH
19
07817
91651
20
07818
91651
21
06110
DR SAFRI
081-355519273 91913
DR SAFRI
22
08084
DR YUSUF ARDIAN
92932
DR YUSUF ARDIAN
23
07199
081-342594689 91831
24
07207
DR. BADARIA
0852-55123030 94665
DR. BADARIA
25
07203
DR. BENNY
081-14138695 94652
DR. BENNY
26
07204
0852-55698977 94652
RI244010
7000
7000
3500
PER/21/062012
01/06/2012
31/05/2013
PER/01/022012
01/03/2012
28/02/2013
PER/13/042012
01/04/2012
31/03/2013
7000
PER/36/112011
01/11/2011
31/10/2012
15000
PER/43/102012
01/10/2012
30/09/2013
7000
PER/35/072012
01/07/2012
30/06/2013
3000
PER/23/JPK-FFS/022010
01/02/2010
31/01/2011
3000
PER/41/092012
01/09/2012
31/08/2013
7000
PER/03/JPK/03212
01/03/2012
28/02/2013
1500
PER/04/JPK/032012
01/03/2012
28/02/2013
1500
PER/07/032012
01/03/2012
28/02/2013
7000
PER/39/092012
01/09/2012
31/08/2013
7000
PER/08/032012
01/03/2012
28/03/2013
15000
PER/10/042012
01/04/2012
31/03/2013
8000
PER/19/042012
01/04/2012
31/03/2013
7000
PER/16/042012
01/04/2012
31/03/2013
8000
7000
PKR102001
Halaman :
Tanggal :
231/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
SABTU, MINGG
PER/29/062012
01/06/2012
31/05/2013
1500
PER/05/062012
01/06/2012
31/05/2013
3500
PER/19/042012
01/04/2012
31/03/2013
7000
PER/22/062012
01/06/2012
31/05/2013
3500
PER/27/032012
01/03/2012
28/02/2013
7000
DRG KUSTIM M SC
PER/06/JPK/032012
01/03/2012
28/02/2013
1500
PER/40/092012
01/09/2012
31/08/2013
7000
91651
DRG PARMITA
PER/05/JPK/032012
01/03/2012
28/02/2013
1500
081-14207670 92971
DRG SURYANI
PER/14/042012
01/04/2012
31/03/2013
7000
94652
PER/31/062012
01/06/2012
31/05/2013
5000
07356
-085255400333 91831
PER/24/062012
01/06/2012
31/05/2013
3500
38
06770
081-1427468
94654
PER/30/062012
01/06/2012
31/05/2013
7000
39
06817
08124-2309986 91913
PER/38/082012
01/08/2012
31/07/2013
7000
40
07206
0852-55949028 94665
PER/09/042012
01/04/2012
31/03/2013
15000
41
06795
08134-2591955 91913
PER/37/082012
01/08/2012
31/07/2013
7000
42
03716
91912
PER/28/052012
01/05/2012
30/04/2013
43
04898
PKM WASUPONDA
94782
DR.ROSMINI
44
04807
94782
45
06815
RS TENTARA PALOPO
JL SAMIUN
91913
46
04827
94782
47
04897
PKM WOWONDULA
94782
48
02925
RS ANDI DJEMMA
0473-21188
91912
0473-21488
PEMERINTAH DAERAH
PER/11/062012
01/06/2012
31/05/2013
7000
49
02361
RS SAWERIGADING
0471-3312133 91912
PER/36/052012
01/05/2012
30/04/2013
7000
50
06580
RSUD I LAGALIGO
94692
RSUD I LAGALIGO
PER/21/042011
01/04/2011
31/03/2012
7000
51
07200
JL A. YANI NO 68 RANTEPAO
0423-21258
91852
PER/02/032011
01/03/2011
29/02/2012
7000
52
04899
PKM WASUPONDA
94782
DR. ROSMINI
27
06647
94652
28
07355
081-342316263 91831
29
07205
DR. SARAH
081-342014844 94665
DR. SARAH
30
07354
0423-23281
91831
31
05596
JL LANDORUNDUN NO 60 RANTEPAO
081-24156723 91831
32
07820
DRG KUSTIM M SC
91651
33
08085
92932
34
07819
DRG PARMITA
35
07881
DRG SURYANI
36
06648
37
RI244010
7000
7000
7000
PER/24/082010
01/08/2010
31/07/2011
10000
7000
7000
PKR102001
Halaman :
Tanggal :
232/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
53
03717
JL SAMIUN PALOPO
0471-326881
21912
54
02363
APOTIK PALOPO
91913
55
JL SAMIUN NO 02 PALOPO
0471-3312133 91913
RI244010
HARI BUKA
PPK II
OPT LAB PEM ABRI BUMN SWASTA
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/34/062012
01/06/2012
31/05/2013
7000
PER/29/072010
01/07/2010
30/06/2011
7000
PER/26/062011
01/06/2011
31/05/2012
PKR102001
Halaman :
Tanggal :
233/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
02114
JL KAMBOJA NO 22 DENPASAR
80111
02116
JL WR SUPRATMAN NO 14 DENPASAR
80111
04862
BP BHAKSENA IDT
80111
05592
BP BHAKSENA TRG
04860
BP-RB NURJAYA
80111
02168
BP/RB-WERDHI AYU/DRG-AYRIANI
80111
02161
DR I KETUT SUARJANA
-0361224105
80111
DR I KETUT SUARJANA
02107
DR AAAA INDRIYANI
JL BATUKARU NO 22 DENPASAR
80111
DR AAA INDRIYANI
02141
DR ARIWIJAYA
80351
10
04399
-0361890789
11
02106
DR ASRI WIRYA
12
02143
13
03882
14
RS
APT
v
v
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/07/122012
01/01/2013
31/12/2013
70000
PER/08/122012
01/01/2013
31/12/2013
40000
PER/36/122012
01/01/2013
31/12/2013
9000
PER/38/122012
01/01/2013
31/12/2013
10000
PER/34/122012
01/01/2013
31/12/2013
10000
PER/30/122012
01/01/2013
31/12/2013
18000
PER/28/122012
01/01/2013
31/12/2013
27000
PER/02/122012
01/01/2013
31/12/2013
500
PER/17/122012
01/01/2013
31/12/2013
20000
80351
PER/33/122012
01/01/2013
31/12/2013
11000
0361-231504
80233
PER/01/122012
01/01/2013
31/12/2013
7500
JL ARJUNA NO 5 NEGARA
82252
PER/44/122012
01/01/2013
31/12/2013
7500
DR DIPAYANA
80351
DR DIPAYANA
PER/31/122012
01/01/2013
31/12/2013
11000
07547
0362-23798
81113
PER/54/122012
01/01/2013
31/12/2013
2500
15
02121
DR I A GITA P(APT.K24.SESETAN)
80111
PER/10/122012
01/01/2013
31/12/2013
17000
16
02123
JL PB SUDIRMAN NO 50 DENPASAR
80111
PER/12/122012
01/01/2013
31/12/2013
16500
17
02109
80111
DR IGP ADI
PER/04/122012
01/01/2013
31/12/2013
7500
18
06753
DR KADEK AWI DP
081-395090959 81111
DR KADEK AWI DP
PER / 52 / 122011
01/01/2012
31/12/2012
19
02122
80111
PER/11/122012
01/01/2013
31/12/2013
9000
20
02108
DR MADE SUDEWI
80111
DR MADE SUDEWI
PER/03/122012
01/01/2013
31/12/2013
800
21
03883
DR N SUARDYATMA
81111
DR SUARDYATMA
PER/40/122012
01/01/2013
31/12/2013
1500
22
02142
80351
PER/18/122012
01/01/2013
31/12/2013
13000
23
04398
80351
PER/32/122012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
GIGI (SHIFT 1), SALIN (SHIFT
KAMIS, JUM'AT,
1,SHIFT 2)
SABTU
01/01/2013
31/12/2013
14000
24
02169
82111
01/01/2013
31/12/2013
9500
RI244010
NI KETUT SENIASIH
DR ASRI WIRYA
PER/51/122012
1000
PKR102001
Halaman :
Tanggal :
234/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
25
02130
82111
26
02157
0361-7870174 80119
27
02127
DR RIZANI
JL PERKUTUT NO 3 SINGARAJA
81111
28
02138
DR SUKADANI
80111
29
02140
JL BATUKARU NO 76 TABANAN
82111
30
02153
JL MALUKU II / 3
31
02180
DR SUYASNI/DRG NL EKAYANTI
JL MALUKU II / 3
32
02119
DR TAMBA
33
02118
34
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/48/122012
01/01/2013
31/12/2013
11500
PER/27/122012
01/01/2013
31/12/2013
17000
DR RIZANI
PER/42/122012
01/01/2013
31/12/2013
7500
DR SUKADANI
PER/15/122012
01/01/2013
31/12/2013
7500
PER/49/122012
01/01/2013
31/12/2013
10000
80111
PER/23/122012
01/01/2013
31/12/2013
18500
80111
PER/23/122012
01/01/2013
31/12/2013
JL ANGGREK NO 23 TABANAN
0361-811456
82111
PER/47/122012
01/01/2013
31/12/2013
12000
DR WAYAN SUBAGIA
JL PETASIKAN II NO 1 JIMBARAN
80351
PER/09/122012
01/01/2013
31/12/2013
20000
02126
80351
PER/14/122012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
GIGI (SHIFT 1), SALIN (SHIFT
KAMIS, JUM'AT,
1,SHIFT 2)
SABTU
01/01/2013
31/12/2013
17000
35
02113
80111
PER/06/122012
01/01/2013
31/12/2013
13500
36
06754
081-24667688 81111
PER/55/122012
01/01/2013
31/12/2013
1000
37
05593
0361-7925770 80351
PER/39/122012
01/01/2013
31/12/2013
10000
38
02156
80111
PER/25/122012
01/01/2013
31/12/2013
34500
39
02144
0361-7494974 80111
PER/19/122012
01/01/2013
31/12/2013
18000
40
02148
-0361233992
80111
PER/21/122012
01/01/2013
31/12/2013
17000
41
05252
DRG L DJASHINTA
80111
PER/37/122012
01/01/2013
31/12/2013
14200
42
02145
DRG LATIFAH
JL A YANI NO 54 SINGARAJA
81111
PER/43/122012
01/01/2013
31/12/2013
25000
43
05594
0361-813070
38611
PER/52/122012
01/01/2013
31/12/2013
10000
44
02151
80351
PER/22/122012
01/01/2013
31/12/2013
16000
45
02149
82252
PER/45/122012
01/01/2013
31/12/2013
20000
46
02147
82111
PER/50/122012
01/01/2013
31/12/2013
16000
47
02155
JL KAMBOJA NO 22 DENPASAR
80111
PER/24/122012
01/01/2013
31/12/2013
18500
48
02139
80111
PER/16/122012
01/01/2013
31/12/2013
17000
RI244010
DR WAYAN SUBAGIA
DRG WEDAGAMA
Halaman :
Tanggal :
235/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
RS
APT
49
02124
KLINIK ANUGERAH
JL NANGKA NO 87 A DENPASAR
80133
50
02110
80351
51
02154
80351
52
07655
0362-94554
81111
0362-94549
DR GEDE P
53
02146
80351
ENDANG BEKTI
54
04861
80111
55
06251
RS INDERA
JL MARUTI NO 10 DENPASAR
80111
56
02170
RSUP SANGLAH
JL DIPONEGORO DPS
0361-227911- 80111
15
57
05336
0362-22046
81111
0362-29629
58
02171
0361-430270
80111
0361-263371
PT IVAN YUNATANA
59
06752
JL CENDRAWASIH NO 5 SINGARAJA
0362-26277
81111
0362-22741
60
06724
0362-32701
81111
0362-29787
DR KOMANG KATRINI
61
02174
0361-234664
80111
62
06252
JL MARUTI NO 18 DENPASAR
80111
63
JALAN DIPONEGORO
0361-227911
80233
0361-224206
64
0361-430270
80233
0361-263371
RI244010
HARI BUKA
PPK II
OPT LAB PEM ABRI BUMN SWASTA
NO IKS
UMUM (SHIFT 1,SHIFT 2),
GIGI (SHIFT 1,SHIFT 2),
SALIN (SHIFT 1,SHIFT 2)
PER/12A/122012
JUMLAH
TTG
31/12/2013
20000
KAMIS, JUM'AT,
SABTU
PER/05/122012
SENIN, SELASA, RABU, UMUM (SHIFT 1,SHIFT 2),
GIGI (SHIFT 1), SALIN (SHIFT
KAMIS, JUM'AT,
1)
SABTU
01/01/2013
31/12/2013
20000
PER/05/122012
01/01/2013
31/12/2013
PER/53/122012
01/01/2013
31/12/2013
1500
PER/20/122012
01/01/2013
31/12/2013
10000
PER/35/122012
01/01/2013
31/12/2013
20000
01/01/2012
31/12/2012
10000
PER / 01 / 062012
01/06/2012
31/05/2013
7000
PER / 54 / 122011
01/01/2012
31/12/2012
15000
PER / 02 / 062012
01/06/2012
31/05/2013
7000
PER / 01 / 062012
01/06/2012
31/05/2013
PER / 03 / 062012
01/06/2012
31/05/2013
10/04/2008
31/05/2013
7000
PER / 55 / 122011
01/01/2012
31/12/2012
1000
PER / 12 / 072012
01/07/2012
30/06/2013
PER/11/122011
28/12/2011
30/11/2012
v
PUTU IVAN YUNATANA
POLA PEMBIAYAAN
JAM BUKA
v
v
v
v
PKR102001
Halaman :
Tanggal :
236/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
02101
07983
0389-21453
07383
DR EKARINI K Y NABU
06603
85327
85711
0389-22763
-085280020032 86161
02099
DR JOANITA A M A TUKAN
0380-
85111
03369
DR RASVITRI UTAMI
0380-
02097
DR YUSTINA TANTRIWULAN
05464
08119
10
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
31/12/2009
7000
7000
PER/16/072012
01/07/2012
30/06/2013
DR EKARINI K Y NABU
PER/06/012012
01/01/2012
31/12/2012
7000
PER/05/012013
01/01/2013
31/12/2013
7000
PER/04/012013
01/01/2013
31/12/2013
7000
85111
PER/03/012013
01/01/2013
31/12/2013
7000
0380-
85111
PER/02/012013
01/01/2013
31/12/2013
7000
0380-
85327
PER/01/012013
01/01/2013
31/12/2013
15000
85111
PER/20/102012
01/11/2012
31/12/2013
8000
07607
0382-21124
86152
PER/07/012013
01/01/2013
31/12/2013
10000
11
04979
85111
12
04874
RS WIRASAKTI
0380-
85111
DR A RUSLI B SP B
13
04504
85327
14
07984
RSUD ATAMBUA
JL DR SUTOMO NO 2 ATAMBUA
0389-21016
85711
0389-21762
15
02102
JL.WAIRKLAU MAUMERE
0382-21617
86152
0382-21314
16
02104
0380-
85327
17
06150
85111
18
05942
85111
19
06602
OPTIK INTERNASIONAL
0380-824333
85227
20
07562
86152
0382-23609
INTERNASIONAL OPTICAL UD
21
07728
0380-828690
85327
22
JL M HOTTA NO 19
85361
RI244010
70
PER/07/012012
01/01/2012
31/12/2012
70
7000
PER/08/012012
01/01/2012
31/12/2012
RSUD ATAMBUA
PER/07/072012
01/07/2012
30/06/2013
PER/366/092011
01/10/2011
31/12/2012
7000
PER/08/012011
01/01/2011
31/12/2011
7000
v
I GEDE KETUT PUTERADANA, SE,
MM
PER/11/012013
01/01/2013
31/12/2013
PER/12/012013
01/01/2013
31/12/2013
PER/14/012013
01/01/2013
31/12/2013
PER/15/012013
01/01/2013
31/12/2013
PER/13/012013
01/01/2013
31/12/2013
PER/09/012012
01/01/2012
31/12/2012
v
v
7000
PKR102001
Halaman :
Tanggal :
237/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
05373
0376-21415
06468
PUSKESMAS PEMENANG
07869
PUSKESMAS ROPANG
05294
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
01/01/2008
31/12/2008
PER/16/012013
01/01/2013
31/12/2013
7000
PER/17/012013
01/01/2013
31/12/2013
7000
PER/23/012012
01/01/2012
31/12/2012
9000
PER/36/112011
01/12/2011
31/12/2012
7000
01/01/2008
31/12/2008
7000
01/01/2012
31/12/2012
70000
PER/04/012013
01/01/2013
31/12/2013
10000
PER/22/072008
01/07/2008
30/06/2009
7000
DR LALU BAHRUDIN
PER/06/012013
01/01/2013
31/12/2013
7000
DR HENRY SANTOSA
PER/09/012013
01/01/2013
31/12/2013
7000
087-865854434 83352
DR HERMANSYAH
PER/07/012013
01/01/2013
31/12/2013
7000
081-326614146 84311
DR HERUMANUDDIN
PER/02/012013
01/01/2013
31/12/2013
7000
DR I WAYAN SUMARJAYA
081-23972944 83111
DR I WAYAN SUMARJAYA
PER/15/012013
01/01/2013
31/12/2013
7000
07696
DR KURNIA AKMAL
081-917300800 83652
DR KURNIA AKMAL
PER/25/022012
01/02/2012
31/12/2012
16
06068
DR LINAH TALIB
JL SOEKARNO-HATTA NO 28 PRAYA
081-23634641 83552
DR LINAH TALIB
PER/10/012013
01/01/2013
31/12/2013
7000
17
06113
DR LYSA MARIAM
081-79364208 83652
DR LYSA MARIAM
PER/11/012013
01/01/2013
31/12/2013
7000
18
08166
DR SULFANI
0821-45374544 84111
DR SULFANI
PER/01/012013
01/01/2013
31/12/2013
7000
19
02082
DR. GUNAWAN
83121
DR GUNAWAN
PER/05/012013
01/01/2013
31/12/2013
7000
20
02085
84311
DR ABDULLAH ALAMUDY
PER/12/012013
01/01/2013
31/12/2013
7000
21
02077
83114
DR KETUT MENDRA
PER/03/012013
01/01/2013
31/12/2013
7000
22
04508
DR.SURE
83123
DR KETUT SURE
PER/08/012013
01/01/2013
31/12/2013
7000
23
06406
081-23748488 83552
PER/14/012013
01/01/2013
31/12/2013
7000
24
04437
0370-637623
PER/13/012013
01/01/2013
31/12/2013
21000
PER/07/012009
01/01/2009
31/12/2009
83652
0376-21415
0821-46888308 83352
H SUHARDI SKM
0878-60101006 84311
R S U MATARAM BERSALIN
JL PEJANGGIK NO 6 MATARAM
0370-623876
83111
PEMDA MATARAM
07714
0370-6660224 83114
DR H LALU HERMAN
MAHAPUTRA
05295
83552
PEMDA LOTENG
05296
JL GARUDA NO 5
0371-21929
84311
0371-23974
02080
0370-628212
83111
0370-628213
03510
DR AA BAGUS PUTRA
83552
DR AA BAGUS PUTRA
10
02081
DR H LALU BAHRUDIN
83363
11
06670
DR HENRY SANTOSA
081-380875558 83127
12
07697
DR HERMANSYAH
13
08165
DR HERUMANUDDIN
14
07800
15
83111
RI244010
7000
7000
PKR102001
Halaman :
Tanggal :
238/239
15-01-2013
16:22:40
PEMILIK
NO
NAMA PPK
NO. PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
25
06069
0370-623010
83352
26
02087
RSU MATARAM
0370-623876
83111
27
07604
0370-6660224 83114
28
02092
0370-6635050 83552
29
02091
0376-21415
30
02090
RSUD SUMBAWA
0371-21929
31
02089
RSUD BIMA
32
02093
0370-638464
33
02095
7000
34
02094
7000
35
05849
OPTIK JAYA
0370-634808
RI244010
PUSKESMAS TANJUNG
PER/23/012012
01/01/2012
31/12/2012
9000
DR H LALU HERMAN
MAHAPUTRA
PER/36/112011
01/12/2011
31/12/2012
7000
PER/21/012012
01/01/2012
31/12/2012
7000
83652
0376-21415
PER/22/012012
01/01/2012
31/12/2012
7000
84311
0371-23974
PEMDA SUMBAWA
PER/20/012012
01/01/2012
31/12/2012
7000
7000
83111
83122
KIMIA FARMA
HJ KUSMIYATI
PER/19/012012
PER/18/012012
01/01/2012
01/01/2012
31/12/2012
31/12/2012
7000
9000
PKR102001
Halaman :
Tanggal :
239/239
15-01-2013
16:22:40
PEMILIK
NO. PPK
NO
NAMA PPK
ALAMAT
TELEPON
KODE
POS
FAX
PIMPINAN
PPK I
U
02185
0361-942082
80552
DR I NYOMAN SUKARTHA
08126
081-936145534 80711
I KETUT PRASIN
06385
DR I MADE ARSAGUNA
JL BHAYANGKARA NO 26
0363-21361
80811
DR I MADE ARSAGUNA
06022
0817-9755694 80811
02136
0363-41378
80852
02132
0361-299461
80552
02131
0366-21624
02137
06019
DRG N L K SRIASIH L
10
05255
11
HARI BUKA
PPK II
S
RS
APT
POLA PEMBIAYAAN
JAM BUKA
NO IKS
JUMLAH
TTG
PER/09/012013
01/01/2013
31/12/2013
7000
PER/16/122012
01/12/2012
31/12/2013
7000
01/01/2013
31/12/2013
7000
PER/13/012013
01/01/2013
31/12/2013
7000
PER/05/012013
01/01/2013
31/12/2013
7000
DR INYOMAM SEDANA
PER/04/012013
01/01/2013
31/12/2013
7000
80500
PER/03/012013
01/01/2013
31/12/2013
7000
0361-970112
80552
DR IGN ADNYANA
PER/06/012013
01/01/2013
31/12/2013
7000
80711
PER/10/012013
01/01/2013
31/12/2013
5000
0361-943440
80511
DRG DGA.TIRTAYASA,S.SOS
PER/08/012013
01/01/2013
31/12/2013
02150
0361-222016
80552
PER/07/012013
01/01/2013
31/12/2013
10000
12
02128
KLINIK KINTAMANI
0366-51201
80651
DR I WAYAN SUDIANA
PER/01/012013
01/01/2013
31/12/2013
7000
13
02129
0361-974573
80552
DR WAYAN ARYAWAN
PER/02/012013
01/01/2013
31/12/2013
10000
14
07365
0366-21172
80711
0366-21371
PEMDA KLUNGKUNG
15
05397
JL CIUNG WENARA NO 1
0316-943020
80511
16
JL RAYA CELUK,SUKAWATI
0361-298233
80511
RI244010
10000
PER/07365/062012
01/06/2012
31/12/2013
15000
PER/001/012012
01/01/2012
31/12/2013
20000
PER/003/012012
01/01/2012
31/12/2012
5000
PKR102001