Provider Demographics
NPI:1407098866
Name:COLON MEDICAL CARE CORP
Entity Type:Organization
Organization Name:COLON MEDICAL CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AXEL
Authorized Official - Middle Name:I
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-223-6032
Mailing Address - Street 1:PO BOX 141225
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614
Mailing Address - Country:US
Mailing Address - Phone:787-223-6032
Mailing Address - Fax:
Practice Address - Street 1:AVE MIRAMAR 650
Practice Address - Street 2:SUITE 3
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-223-6032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 5783416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport