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General NPI Number Information
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NPI Number | 1386962124
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE AMBULANCE INC
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Dates
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Enumeration Date | 05/04/2010
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Last Update Date | 05/04/2010
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Provider Practice Location Address
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Address Line | CARR 861 # KM 4/5 BO BUCARABONES
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City | TOA ALTA
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State | PR
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Zip | 00953-8528
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Country | US
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Telephone | 787-373-9696
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Fax | 787-786-0022
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Provider Business Mailing Address
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Address Line | CARR. 861 KM 4.5 BO. BUCARABONES
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City | TOA ALTA
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State | PR
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Zip | 00953
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Country | US
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Telephone | 787-373-9696
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Fax | 787-786-0022
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOEL PASTRANA
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Credential |
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Telephone | 787-373-9696
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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-642
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License Number State | PR
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