Provider Demographics
NPI:1376760058
Name:STAR LIFE AMBULANCES, INC.
Entity Type:Organization
Organization Name:STAR LIFE AMBULANCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCOS
Authorized Official - Middle Name:
Authorized Official - Last Name:ALICEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-873-5723
Mailing Address - Street 1:HC 10 BOX 8100
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-9719
Mailing Address - Country:US
Mailing Address - Phone:787-873-5723
Mailing Address - Fax:787-267-2476
Practice Address - Street 1:CARR. 328 KM. 4.3
Practice Address - Street 2:BO. RAYO GUARAS
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637
Practice Address - Country:US
Practice Address - Phone:787-873-5723
Practice Address - Fax:787-267-2476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB-456341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance