1831340934 NPI number — RESCUE FOR LIFE AMBULANCE CORP

Table of content: (NPI 1831340934)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831340934 NPI number — RESCUE FOR LIFE AMBULANCE CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RESCUE FOR LIFE 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:
1831340934
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB VILLA CLARITA CALLE 1 H9
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAJARDO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00738
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-436-1644
Provider Business Mailing Address Fax Number:
787-889-0911

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
URB VILLA CLARITA CALLE 1 H9
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAJARDO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-436-1644
Provider Business Practice Location Address Fax Number:
787-889-0911
Provider Enumeration Date:
10/07/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SANTIAGO
Authorized Official First Name:
YOKANI
Authorized Official Middle Name:
LY
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-436-1644

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  4782777 , 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: 2003-443 . This is a "TECNICO DE EMERGENCIAS MEDICAS BASICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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