1457053894 NPI number — CAMILA MEDICAL TRANSPORT LLC

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 1457053894 NPI number — CAMILA MEDICAL TRANSPORT LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAMILA MEDICAL TRANSPORT LLC
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:
1457053894
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 494
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
QUEBRADILLAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00678-0494
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:
CARR #2 KM 95.4
Provider Second Line Business Practice Location Address:
MARGINAL BO. YEGUADA
Provider Business Practice Location Address City Name:
CAMUY
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00627
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-210-2463
Provider Business Practice Location Address Fax Number:
787-395-7905
Provider Enumeration Date:
03/20/2023

Additional Information

Authorized Official

Authorized Official Last Name:
MEDINA
Authorized Official First Name:
DAISY
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRADORA
Authorized Official Telephone Number:
787-210-2463

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)





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