1831338920 NPI number — JES MAR AMBULANCE INC

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 1831338920 NPI number — JES MAR AMBULANCE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JES MAR 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:
1831338920
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/12/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HC 3 BOX 12080
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAROLINA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00987
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-486-9604
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 853 KM 13.6
Provider Second Line Business Practice Location Address:
BO CEDRO
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:
787-486-9604
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/12/2009

Additional Information

Authorized Official

Authorized Official Last Name:
CARRASQUILLO
Authorized Official First Name:
MARA
Authorized Official Middle Name:
ANGELY
Authorized Official Title or Position:
PRESIDENTA
Authorized Official Telephone Number:
787-627-7657

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)

  • Identifier: CK144A . This is a "NUMERO PROVEEDOR MEDICARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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