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General NPI Number Information
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NPI Number | 1194916148
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Entity Type | Organization
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Legal Business Name | HATIMED AMBULANCE SERVICE CORP.
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 905 AVE SAN LUIS
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City | ARECIBO
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State | PR
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Zip | 00612-3834
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Country | US
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Telephone | 787-566-6200
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Fax | 787-820-5866
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Provider Business Mailing Address
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Address Line | B1 CALLE MIGUEL GONZALEZ HATILLO DEL MAR
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City | HATILLO
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State | PR
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Zip | 00659-2220
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Country | US
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Telephone | 787-566-6200
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Fax | 787-820-5866
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. BRENDA A SEPULVADO
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Credential |
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Telephone | 787-356-8136
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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 | TC AMB 540
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License Number State | PR
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