Healthcare Provider Details

I. General information

NPI: 1386184398
Provider Name (Legal Business Name): HEALTH TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2017
Last Update Date: 02/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7-1 PALENQUE 1A
BARCELONETA PR
00617
US

IV. Provider business mailing address

7-1 PALENQUE 1A
BARCELONETA PR
00617
US

V. Phone/Fax

Practice location:
  • Phone: 939-261-0208
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number4764057
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number4764057
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number4764057
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierPCVTE-4786
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerCSP

VIII. Authorized Official

Name: LADY RIVERA
Title or Position: PRESIDENTA EJECUTIVA
Credential:
Phone: 413-275-9406