1083835243 NPI number — PEDRO LUGO

Table of content: (NPI 1083835243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083835243 NPI number — PEDRO LUGO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PEDRO LUGO
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:
LUGO AMBULANCE SERVICE
Provider Other Organization Name Type Code:
3
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:
1083835243
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:
RR 3 BUZON 10807
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANASCO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00610
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-826-2525
Provider Business Mailing Address Fax Number:
787-818-0429

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 109, KM. 5.3
Provider Second Line Business Practice Location Address:
BO ESPINO
Provider Business Practice Location Address City Name:
ANASCO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-826-2525
Provider Business Practice Location Address Fax Number:
787-818-0429
Provider Enumeration Date:
05/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LUGO
Authorized Official First Name:
PEDRO
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-826-2525

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  TC AMB 424 , 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: 50740 . This is a "PMC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 69277 . This is a "AMERICAN HEALTH MEDICARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com