1366410391 NPI number — CORREA AMBULANCE SERVICE INC.

Table of content: (NPI 1366410391)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366410391 NPI number — CORREA AMBULANCE SERVICE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORREA AMBULANCE SERVICE 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:
1366410391
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:
HC 3 BOX 4295
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GURABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00778-9707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
STREET-1 #35 PARCELAS CELADA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GURABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00778-9707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-737-2484
Provider Business Practice Location Address Fax Number:
787-737-5556
Provider Enumeration Date:
03/08/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CORREA
Authorized Official First Name:
MIGUEL
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
PRESIDENTE
Authorized Official Telephone Number:
787-737-2484

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , 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)