1710990155 NPI number — MILLENNIUM AMBULANCE, 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 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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