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General NPI Number Information
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NPI Number | 1760135008
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Entity Type | Organization
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Legal Business Name | CC AMBULANCE LLC
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Dates
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Enumeration Date | 01/27/2022
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | CALLE DIXON 23
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City | COAMO
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State | PR
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Zip | 00769
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Country | US
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Telephone | 787-247-3684
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Fax |
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Provider Business Mailing Address
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Address Line | HC 2 BOX 8027
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City | VILLALBA
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State | PR
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Zip | 00766
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Country | US
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Telephone | 787-247-3684
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EVELYN NEGRON COLLAZO
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Credential |
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Telephone | 787-247-3684
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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 |
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License Number State |
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