Healthcare Provider Details

I. General information

NPI: 1346499522
Provider Name (Legal Business Name): INTERBUS, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2008
Last Update Date: 09/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4309 CARR #2 KM 43.3 BA. ALGARROBO
VEGA BAJA PR
00693
US

IV. Provider business mailing address

4309 CARR 2 # KM43.3 ALGARROBO
VEGA BAJA PR
00693-4141
US

V. Phone/Fax

Practice location:
  • Phone: 787-858-7581
  • Fax: 787-855-1573
Mailing address:
  • Phone: 787-858-7581
  • Fax: 787-855-1573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberS-08-42-PC-4410
License Number StatePR

VIII. Authorized Official

Name: MRS. ANGEL M VELEZ
Title or Position: PRESIDENT
Credential:
Phone: 787-858-7581