Provider Demographics
NPI:1073205605
Name:PROMEDICAL AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:PROMEDICAL AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:MIGUEL
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-340-3999
Mailing Address - Street 1:PO BOX 1035
Mailing Address - Street 2:
Mailing Address - City:PENUELAS
Mailing Address - State:PR
Mailing Address - Zip Code:00624-1035
Mailing Address - Country:US
Mailing Address - Phone:787-340-3999
Mailing Address - Fax:
Practice Address - Street 1:BARRIO COTTO QUEBRADA SECTOR LOS CASTRO
Practice Address - Street 2:CARRETERA 383 KM 0.5
Practice Address - City:PENUELAS
Practice Address - State:PR
Practice Address - Zip Code:00624
Practice Address - Country:US
Practice Address - Phone:787-340-3999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport