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General NPI Number Information
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NPI Number | 1053136309
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Entity Type | Organization
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Legal Business Name | LEGACY CRITICAL CARE AMBULANCE LLC
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | CARR 31 MARGINAL 56C URB VALENCIA I
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City | JUNCOS
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State | PR
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Zip | 00777
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Country | US
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Telephone | 787-922-6955
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1872
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City | JUNCOS
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State | PR
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Zip | 00777-1872
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | GRETCHEN M FIGUEROA
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Credential |
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Telephone | 787-922-6955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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