Provider Demographics
NPI:1043406952
Name:ELDERLY TRANSPORTATION SERVICES, LLC
Entity Type:Organization
Organization Name:ELDERLY TRANSPORTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-771-6900
Mailing Address - Street 1:1404 AVE PAZ GRANELA
Mailing Address - Street 2:PMB 218 SUITE 2
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-4131
Mailing Address - Country:US
Mailing Address - Phone:787-771-6900
Mailing Address - Fax:787-771-6901
Practice Address - Street 1:EDIF ALB PLAZA CARR 199 SUITE 16
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-771-6900
Practice Address - Fax:787-771-6901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347B00000XTransportation ServicesBus