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General NPI Number Information
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NPI Number | 1376760058
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Entity Type | Organization
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Legal Business Name | STAR LIFE AMBULANCES, INC.
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CARR. 328 KM. 4.3 BO. RAYO GUARAS
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City | SABANA GRANDE
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State | PR
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Zip | 00637
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Country | US
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Telephone | 787-873-5723
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Fax | 787-267-2476
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Provider Business Mailing Address
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Address Line | HC 10 BOX 8100
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City | SABANA GRANDE
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State | PR
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Zip | 00637-9719
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Country | US
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Telephone | 787-873-5723
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Fax | 787-267-2476
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARCOS ALICEA
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Credential |
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Telephone | 787-873-5723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | TCAMB-456
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License Number State | PR
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