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General NPI Number Information
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NPI Number | 1720243314
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Entity Type | Organization
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Legal Business Name | YOUR LIFE AMBULANCE, CORP
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | CALLE 2 ALTURAS DE RIO GRANDE B-89
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City | RIO GRANDE
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State | PR
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Zip | 00745
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Country | US
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Telephone | 787-292-9922
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Fax |
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Provider Business Mailing Address
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Address Line | CALLE 2 ALTURAS DE RIO GRANDE B-89
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City | RIO GRANDE
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State | PR
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Zip | 00745
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Country | UM
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Telephone | 2929922
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | ELEXS RUIZ ARJEMI SR.
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Credential |
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Telephone | 787-292-9922
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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 | 4051734
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License Number State | PR
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