Provider Demographics
NPI:1376249524
Name:DYNASTY EMERGENCY MEDICAL SERVICE CORP
Entity Type:Organization
Organization Name:DYNASTY EMERGENCY MEDICAL SERVICE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:J
Authorized Official - Last Name:RIVERA MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-481-7592
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:787-874-8175
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION INTERAMERICANA
Practice Address - Street 2:CALLE 15 AD13
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-3407
Practice Address - Country:US
Practice Address - Phone:787-481-7592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport