Healthcare Provider Details

I. General information

NPI: 1205250180
Provider Name (Legal Business Name): SENIOR CARE TRANSPORTATION CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2014
Last Update Date: 02/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BDA, BALDORIOLY #579
PONCE PR
00717
US

IV. Provider business mailing address

BES, BALDOROOTY #579 URB, LOS MAESTROS CALLE MARTIN CORCHADO #8234
PONCE PR
00717-0254
US

V. Phone/Fax

Practice location:
  • Phone: 787-507-0371
  • Fax: 787-507-0371
Mailing address:
  • Phone: 787-507-0371
  • Fax: 787-507-0371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES EDWARD JOHNSON SR.
Title or Position: PRESIDENT
Credential: LPN
Phone: 787-507-0371