1285824714 NPI number — ROSARIO MEDICAL TRANSPORT

Table of content: (NPI 1285824714)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285824714 NPI number — ROSARIO MEDICAL TRANSPORT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROSARIO MEDICAL TRANSPORT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285824714
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HC 56 BOX 34266
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AGUADA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00602-9772
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
939-644-6709
Provider Business Mailing Address Fax Number:
787-818-0429

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 417 KM 2.5 INT
Provider Second Line Business Practice Location Address:
BO MALPASO SECTOR CESAR RUIZ
Provider Business Practice Location Address City Name:
AGUADA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00602-9772
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
939-644-6709
Provider Business Practice Location Address Fax Number:
787-818-0429
Provider Enumeration Date:
07/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ROSARIO CRESPO
Authorized Official First Name:
EDWIN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
939-644-6709

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  P1377 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: TC AMB 480 . This is a "COMISION SERVICIO PUBLICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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