Provider Demographics
NPI:1073193843
Name:CITYWIDE AMBULANCE, LLC
Entity Type:Organization
Organization Name:CITYWIDE AMBULANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BORIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-359-3749
Mailing Address - Street 1:URBANIZACION EL CORTIJO CALLE 16 N 2
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-359-3749
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION EL CORTIJO CALLE 16 N 2
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-359-3749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport