Provider Demographics
NPI:1114929593
Name:HOGAR GERIATRICO EMMANUEL,INC.
Entity Type:Organization
Organization Name:HOGAR GERIATRICO EMMANUEL,INC.
Other - Org Name:EMMANUEL AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SONERA
Authorized Official - Suffix:
Authorized Official - Credentials:RN,MPH
Authorized Official - Phone:787-898-1512
Mailing Address - Street 1:PO BOX 170
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-0170
Mailing Address - Country:US
Mailing Address - Phone:787-898-1512
Mailing Address - Fax:787-898-2392
Practice Address - Street 1:BARRIO PUERTOS
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-0170
Practice Address - Country:US
Practice Address - Phone:787-898-1512
Practice Address - Fax:787-898-2392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB3003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0055465Medicare UPIN