1316693872 NPI number — CRITICAL HEALTH AMBULANCE CORP

Table of content: (NPI 1316693872)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316693872 NPI number — CRITICAL HEALTH AMBULANCE CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CRITICAL HEALTH 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:
1316693872
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HC 8 BOX 24426
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AGUADILLA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00603-9644
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-313-6498
Provider Business Mailing Address Fax Number:
787-551-7104

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 4110 KM 0.3
Provider Second Line Business Practice Location Address:
BO CAIMITAL BAJO
Provider Business Practice Location Address City Name:
AGUADILLA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-313-6498
Provider Business Practice Location Address Fax Number:
787-551-7104
Provider Enumeration Date:
02/23/2022

Additional Information

Authorized Official

Authorized Official Last Name:
MENDEZ FRONTERAS
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-313-6498

Provider Taxonomy Codes

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

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

  • Identifier: TCAMB-135556 . This is a "TCAMB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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