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General NPI Number Information
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NPI Number | 1649411414
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Entity Type | Organization
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Legal Business Name | EXCELLENT AMBULANCE SERVICE, INC.
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Dates
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Enumeration Date | 03/09/2009
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Last Update Date | 03/09/2009
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Provider Practice Location Address
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Address Line | 138 AVE WINSTON CHURCHILL PMB 680
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City | SAN JUAN
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State | PR
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Zip | 00926-6023
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Country | US
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Telephone | 787-292-4540
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Fax | 787-292-1974
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Provider Business Mailing Address
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Address Line | 138 AVE WINSTON CHURCHILL PMB 680
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City | SAN JUAN
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State | PR
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Zip | 00926-6023
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Country | US
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Telephone | 787-292-4540
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Fax | 787-292-1974
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Authorized Official
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Title or Position | PRESIDENTA
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Name | MS. GINEYRA D. RODRIGUEZ I
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Credential |
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Telephone | 787-292-4540
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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 579
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License Number State | PR
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