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NPI 1073205605

NPI 1073205605 : PROMEDICAL AMBULANCE SERVICE INC : PENUELAS, PR

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General NPI Number Information
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    NPI Number           |    1073205605
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    Entity Type          |    Organization 
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    Legal Business Name  |    PROMEDICAL AMBULANCE SERVICE INC 
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Dates
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    Enumeration Date     |    05/23/2023
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    Last Update Date     |    05/23/2023
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Provider Practice Location Address
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    Address Line         |    BARRIO COTTO QUEBRADA SECTOR LOS CASTRO CARRETERA 383 KM 0.5
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    City                 |    PENUELAS
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    State                |    PR
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    Zip                  |    00624
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    Country              |    US
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    Telephone            |    787-340-3999
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1035 
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    City                 |    PENUELAS
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    State                |    PR
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    Zip                  |    00624-1035
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    Country              |    US
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    Telephone            |    787-340-3999
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     JESUS MIGUEL CASTRO 
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    Credential           |    
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    Telephone            |    787-340-3999
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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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