Healthcare Provider Details

I. General information

NPI: 1023401395
Provider Name (Legal Business Name): P.R.A.S. PUERTO RICO AMBULETTE SERVICE COPR.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 03/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NUMERO 910 AVE. CAMPO RICO URB. COUNTRY CLUB
SAN JUAN PR
00924-9999
US

IV. Provider business mailing address

#910 AVE CAMPO RICO URB COUNTRY CLUB INTERIOR
SAN JUAN PR
00924-9999
US

V. Phone/Fax

Practice location:
  • Phone: 787-752-1019
  • Fax: 787-768-2673
Mailing address:
  • Phone: 787-752-1019
  • Fax: 787-768-2673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberPCVTE/PCVTI-4442
License Number StatePR

VIII. Authorized Official

Name: GIOVANNI SALERNO
Title or Position: OWNER
Credential:
Phone: 787-752-1019