1306130935 NPI number — PEDIATRIC & ADULT MEDICAL SERVICE, AMBULANCE INC

Table of content: (NPI 1306130935)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306130935 NPI number — PEDIATRIC & ADULT MEDICAL SERVICE, AMBULANCE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PEDIATRIC & ADULT MEDICAL SERVICE, AMBULANCE INC
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:
1306130935
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2367
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANOVANAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00729-2367
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-671-9952
Provider Business Mailing Address Fax Number:
787-762-5161

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE 20 R 1 CIUDAD UNIVERSITARIA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TRUJILLO ALTO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00976
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-671-9952
Provider Business Practice Location Address Fax Number:
787-762-5161
Provider Enumeration Date:
05/31/2011

Additional Information

Authorized Official

Authorized Official Last Name:
MARTINEZ
Authorized Official First Name:
PEDRO
Authorized Official Middle Name:
JUAN
Authorized Official Title or Position:
AUTHORIZED REPRESENTATIVE
Authorized Official Telephone Number:
787-671-9952

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  2579696 , 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)





Copyright © 2007-2025 www.npivalidator.com