1861135063 NPI number — PUERTO RICO EMERGENCY MEDICAL SERVICE AND TRANSPORTATION 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 1861135063 NPI number — PUERTO RICO EMERGENCY MEDICAL SERVICE AND TRANSPORTATION CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PUERTO RICO EMERGENCY MEDICAL SERVICE AND TRANSPORTATION 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:
1861135063
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 448
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA ISABEL
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00757-0448
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-904-0301
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE MIRAMAR 25A
Provider Second Line Business Practice Location Address:
PLAYITA CORTADA
Provider Business Practice Location Address City Name:
SANTA ISABEL
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00757
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-904-0301
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/15/2022

Additional Information

Authorized Official

Authorized Official Last Name:
FAMANIA MORALES
Authorized Official First Name:
JOSUE
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-904-0301

Provider Taxonomy Codes

  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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