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General NPI Number Information
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NPI Number | 1679584122
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Entity Type | Organization
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Legal Business Name | RENAL CARE AMBULANCE, INC.
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | AVE. 65 INFANTERIA KM 2.0 OFFICE 22
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City | SAN JUAN
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State | PR
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Zip | 00926-1910
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Country | US
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Telephone | 787-754-8361
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 194000 SUITE114
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City | SAN JUAN
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State | PR
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Zip | 00919-4000
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Country | US
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Telephone | 787-751-1374
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Fax | 787-767-4202
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARITZA A RODRIGUEZ
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Credential |
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Telephone | 787-751-1374
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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-328
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License Number State | PR
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