MEDICARE: VERECTOR MEDICAL TRANSPORT, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1063413763
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VERECTOR MEDICAL TRANSPORT, INC.

Provider Business Mailing Address
First Line	:	HC 1 BOX 6294
Second Line	:
City	:	LAS PIEDRAS
State	:	PR
Zip	:	00771-9721
Country	:	US
Telephone Number	:	787-852-8878
Fax Number	:	787-852-8878

Provider Business Practice Location Address
First Line	:	BO. COLLORES
Second Line	:	CARR 922 K0 H5
City	:	LAS PIEDRAS
State	:	PR
Zip	:	00771
Country	:	US
Telephone Number	:	787-852-8878
Fax Number	:	787-852-8878

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. VERONICA HERNANDEZ SIERRA
Credential	:
Telephone Number	:	787-852-8878

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	08/22/2020

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