Provider Demographics
NPI:1023401395
Name:P.R.A.S. PUERTO RICO AMBULETTE SERVICE COPR.
Entity Type:Organization
Organization Name:P.R.A.S. PUERTO RICO AMBULETTE SERVICE COPR.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GIOVANNI
Authorized Official - Middle Name:
Authorized Official - Last Name:SALERNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-752-1019
Mailing Address - Street 1:#910 AVE CAMPO RICO
Mailing Address - Street 2:URB COUNTRY CLUB INTERIOR
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-9999
Mailing Address - Country:US
Mailing Address - Phone:787-752-1019
Mailing Address - Fax:787-768-2673
Practice Address - Street 1:NUMERO 910 AVE. CAMPO RICO
Practice Address - Street 2:URB. COUNTRY CLUB
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-9999
Practice Address - Country:US
Practice Address - Phone:787-752-1019
Practice Address - Fax:787-768-2673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRPCVTE/PCVTI-4442343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)