1194916148 NPI number — HATIMED AMBULANCE SERVICE CORP.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194916148 NPI number — HATIMED AMBULANCE SERVICE CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HATIMED AMBULANCE SERVICE 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:
1194916148
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
B1 CALLE MIGUEL GONZALEZ
Provider Second Line Business Mailing Address:
HATILLO DEL MAR
Provider Business Mailing Address City Name:
HATILLO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00659-2220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-566-6200
Provider Business Mailing Address Fax Number:
787-820-5866

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
905 AVE SAN LUIS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612-3834
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-566-6200
Provider Business Practice Location Address Fax Number:
787-820-5866
Provider Enumeration Date:
08/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SEPULVADO
Authorized Official First Name:
BRENDA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-356-8136

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  TC AMB 540 , 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)





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