Healthcare Provider Details

I. General information

NPI: 1164539300
Provider Name (Legal Business Name): RICHARD AQUINO EMT-B
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USAHC GRFENWOEHR
APO AE
09114
US

IV. Provider business mailing address

CMR 415 BOX 4891
APO AE
09114
US

V. Phone/Fax

Practice location:
  • Phone: 499641837152
  • Fax:
Mailing address:
  • Phone: 499641838576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberB1146865
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: