1861674657 NPI number — SANABRIA EMERGENCY MEDICAL SERVICE CORP.

Table of content: (NPI 1861674657)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861674657 NPI number — SANABRIA EMERGENCY MEDICAL SERVICE CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SANABRIA EMERGENCY MEDICAL SERVICE 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:
1861674657
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/22/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
236-1 AVE MONTEMAR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AGUADILLA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00603-5583
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-363-7968
Provider Business Mailing Address Fax Number:
787-891-4803

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR. 467 KM2.2. BO. BORINQUEN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AGUADILLA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-363-7968
Provider Business Practice Location Address Fax Number:
787-891-4803
Provider Enumeration Date:
12/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SANABRIA
Authorized Official First Name:
NELSON
Authorized Official Middle Name:
I
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-882-6301

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  TC AMB 567 , 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)





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