1710990155 NPI number — MILLENNIUM AMBULANCE, CORP.

Table of content: (NPI 1710990155)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710990155 NPI number — MILLENNIUM AMBULANCE, CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MILLENNIUM AMBULANCE, CORP.
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:
1710990155
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1517
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RINCON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00677-1517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-823-4383
Provider Business Mailing Address Fax Number:
787-823-4343

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 115 KM 11.1
Provider Second Line Business Practice Location Address:
BO PUEBLO
Provider Business Practice Location Address City Name:
RINCON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00677
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-823-4383
Provider Business Practice Location Address Fax Number:
787-823-4343
Provider Enumeration Date:
08/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MUNOZ
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-549-1150

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  TC AMB 425 , 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: 90-05196 . This is a "ACAA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 57991 MI . This is a "TRIPLE S OPTIMO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 890622 . This is a "MEDICARE Y MUCHO MAS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 3847 . This is a "APS HEALTHCARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 50739 . This is a "PREFFERED MEDICAL CHOICE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6770011 . This is a "HUMANA HEALTH PLANS OF PUERTO RICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 12268 . This is a "PROSALUD HMO CORP." identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 57991 . This is a "TRIPLE-S, MEDICARE SELECTO PLATINO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 57991 MI . This is a "TRIPLE- C, INC." identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6676 . This is a "AMERICAN HEALTH MEDICARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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