Provider Demographics
NPI:1346217379
Name:QUALITY MEDICAL TRANSPORT AMBULANCE SERVICE CORP
Entity Type:Organization
Organization Name:QUALITY MEDICAL TRANSPORT AMBULANCE SERVICE CORP
Other - Org Name:QUALITY AMBULANCE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:E
Authorized Official - Last Name:RIVERA DE JESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-969-9162
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00977-0280
Mailing Address - Country:US
Mailing Address - Phone:939-969-9162
Mailing Address - Fax:787-748-5797
Practice Address - Street 1:CARR 851 K0 H7
Practice Address - Street 2:BO LA GLORIA
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:939-969-9162
Practice Address - Fax:787-748-5797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB 2993416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport