Provider Demographics
NPI:1427357862
Name:THE GOLDEN FENNIX AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:THE GOLDEN FENNIX AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MS
Authorized Official - First Name:WILMA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:TEMP
Authorized Official - Phone:787-452-4259
Mailing Address - Street 1:PO BOX 144100
Mailing Address - Street 2:ARECIBO, PMB 160
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614
Mailing Address - Country:US
Mailing Address - Phone:787-452-4259
Mailing Address - Fax:
Practice Address - Street 1:BUENOS AIRES
Practice Address - Street 2:CALLE JOSE OLMO 317
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00614
Practice Address - Country:US
Practice Address - Phone:787-452-4259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1951486341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance