1710975131 NPI number — B M PROFESSIONAL CARE AMBULANCE

Table of content: (NPI 1710975131)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710975131 NPI number — B M PROFESSIONAL CARE AMBULANCE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
B M PROFESSIONAL CARE AMBULANCE
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:
1710975131
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 6017
Provider Second Line Business Mailing Address:
PMB 596
Provider Business Mailing Address City Name:
CAROLINA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00984-6017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-276-6565
Provider Business Mailing Address Fax Number:
787-701-1728

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARRETERA 848KM
Provider Second Line Business Practice Location Address:
2.8 SAINT JUST
Provider Business Practice Location Address City Name:
CAROLINA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00987
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-276-6565
Provider Business Practice Location Address Fax Number:
787-701-1728
Provider Enumeration Date:
10/10/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GARCIA
Authorized Official First Name:
BRENDA
Authorized Official Middle Name:
MALDONADO
Authorized Official Title or Position:
PRESIDENTA
Authorized Official Telephone Number:
787-276-6565

Provider Taxonomy Codes

  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5 7009BM . This is a "S S S" identifier . This identifiers is of the category "OTHER".
  • Identifier: 890407 . This is a "M M M" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9004491 . This is a "ACCA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9870020 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".