Provider Demographics
NPI:1376738914
Name:LIFE LINK AMBULANCE CORP
Entity Type:Organization
Organization Name:LIFE LINK AMBULANCE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-366-7577
Mailing Address - Street 1:PO BOX 31003
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-2003
Mailing Address - Country:US
Mailing Address - Phone:787-366-7577
Mailing Address - Fax:
Practice Address - Street 1:J13 CALLE 2
Practice Address - Street 2:URB. BRISAS DEL MAR
Practice Address - City:LUQUILLO
Practice Address - State:PR
Practice Address - Zip Code:00773-2458
Practice Address - Country:US
Practice Address - Phone:787-366-7577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC-AMB-4923416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport