=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629325543
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRANSPORTES MEDICOS DE PUERTO RICO
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/09/2012
-----------------------------------------------------
Last Update Date | 08/09/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | PUERTO RICO MEDICAL CENTER HELIPUERTO
-----------------------------------------------------
City | RIO PIEDRAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00935
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-765-3944
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10888 S 300 W
-----------------------------------------------------
City | SOUTH JORDAN
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84095-4043
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-619-4900
-----------------------------------------------------
Fax | 801-619-8077
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. JOSEPH HUNT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 801-619-4900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416A0800X
-----------------------------------------------------
Taxonomy Name | Air Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------