1972777191 NPI number — PRO CARE PARAMEDIC GROUP, CORP.

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 1972777191 NPI number — PRO CARE PARAMEDIC GROUP, CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRO CARE PARAMEDIC GROUP, 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:
1972777191
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2992
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00681-2992
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-831-2028
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 CALLE MAXIMINO BARBOSA STE 4
Provider Second Line Business Practice Location Address:
BO. RIO HONDO
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00680-7104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-831-2028
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MONTALVO
Authorized Official First Name:
JOSE
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-519-0050

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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