1922056605 NPI number — NATANAELL AMBULANCE INC

Table of content: JENNIFER R. CHAN M.D. (NPI 1396756102)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922056605 NPI number — NATANAELL AMBULANCE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATANAELL 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:
1922056605
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2407
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COAMO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00769-4407
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-837-6878
Provider Business Mailing Address Fax Number:
787-842-1032

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BO LLANOS URB LLANURAS DE BARCELOA
Provider Second Line Business Practice Location Address:
CALLE 1 SOLAR 2 A
Provider Business Practice Location Address City Name:
COAMO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00769
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-837-6878
Provider Business Practice Location Address Fax Number:
787-842-1032
Provider Enumeration Date:
05/04/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VICENTE
Authorized Official First Name:
ALEXIS
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-837-6878

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  TC AMB 229 , 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)