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General NPI Number Information
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NPI Number | 1275289860
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Entity Type | Organization
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Legal Business Name | J M TRANSPORT #1 CORP
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Dates
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Enumeration Date | 02/23/2022
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | CARR PR-484 KM 0.5 INT CALLE LOS LUGO BO COCOS
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City | QUEBRADILLAS
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State | PR
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Zip | 00678
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Country | US
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Telephone | 939-638-2296
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Fax | 787-551-7104
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Provider Business Mailing Address
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Address Line | PO BOX 339
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City | QUEBRADILLAS
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State | PR
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Zip | 00678-0339
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Country | US
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Telephone | 939-638-2296
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Fax | 787-551-7104
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA M GANDIA LUGO
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Credential |
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Telephone | 939-639-6697
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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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