Healthcare Provider Details

I. General information

NPI: 1457220550
Provider Name (Legal Business Name): TAG INTERESTS USVI 2 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 11/05/2025
Certification Date: 10/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 KONGENS GADE
ST THOMAS VI
00801
US

IV. Provider business mailing address

PO BOX 12501
ST THOMAS VI
00801-8501
US

V. Phone/Fax

Practice location:
  • Phone: 859-878-5950
  • Fax:
Mailing address:
  • Phone: 859-878-5950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3416S0300X
TaxonomyWater Ambulance
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MARLON HERNANDEZ
Title or Position: PARNTER
Credential:
Phone: 859-878-5950