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General NPI Number Information
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NPI Number | 1932427416
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Entity Type | Organization
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Legal Business Name | PROMEDIC HEALTH CARE AMBULANCE, CORP
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Dates
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Enumeration Date | 05/10/2010
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Last Update Date | 05/10/2010
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Provider Practice Location Address
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Address Line | #66 C-37 CARRION STREET URB. COLINAS SAN AGUSTIN
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City | LAS PIEDRAS
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State | PR
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Zip | 00771
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Country | US
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Telephone | 787-733-1458
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Fax | 787-733-1458
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Provider Business Mailing Address
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Address Line | PO BOX 1435
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City | LAS PIEDRAS
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State | PR
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Zip | 00771-1435
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Country | US
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Telephone | 787-733-1458
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Fax | 787-733-1458
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Authorized Official
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Title or Position | OWNER-OPERATOR
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Name | MR. JOSEPH MELENDEZ PAGAN
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Credential | EMT
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Telephone | 787-212-4871
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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 | 2356 PARAMEDIC
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License Number State | PR
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