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General NPI Number Information
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NPI Number | 1356610554
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Entity Type | Organization
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Legal Business Name | GOBIERNO MUNICIPAL GUAYAMA
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Dates
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Enumeration Date | 12/19/2011
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Last Update Date | 06/06/2012
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Provider Practice Location Address
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Address Line | CARRETERA NUM 3 ESQUINA CARRETERA MACHETE
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City | GUAYAMA
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State | PR
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Zip | 00784
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Country | US
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Telephone | 787-864-0600
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Fax | 787-866-6644
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Provider Business Mailing Address
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Address Line | PO BOX 360
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City | GUAYAMA
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State | PR
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Zip | 00784
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Country | US
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Telephone | 787-864-0600
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Fax | 787-864-5070
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Authorized Official
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Title or Position | DIRECTOR
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Name | PAUL G FRET
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Credential |
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Telephone | 787-864-0600
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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 679
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License Number State | PR
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