MEDICARE: PRIMEROS AUXILIOS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	TCAMB-439	PR

General Provider Information

NPI Number	:	1255478319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMEROS AUXILIOS, INC.

Provider Business Mailing Address
First Line	:	PMB 237-220 SUITE 101
Second Line	:	WESTERN AUTO PLAZA
City	:	TRUJILLO ALTO
State	:	PR
Zip	:	00976-0001
Country	:	US
Telephone Number	:	787-272-1199
Fax Number	:	787-272-1190

Provider Business Practice Location Address
First Line	:	CARR. 1 RD 842 KM 1.4
Second Line	:	CAIMITO BAJO, RIO PIEDRAS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-0001
Country	:	US
Telephone Number	:	787-272-1199
Fax Number	:	787-272-1190

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIA SANTIAGO
Credential	:
Telephone Number	:	787-272-1199

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	08/19/2013

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