Provider Demographics
NPI: | 1467687285 |
---|---|
Name: | EXCLUSIVE AMBULANCE SERVICES INC. |
Entity Type: | Organization |
Organization Name: | EXCLUSIVE AMBULANCE SERVICES INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | IRVING |
Authorized Official - Middle Name: | J |
Authorized Official - Last Name: | VELEZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 787-486-3225 |
Mailing Address - Street 1: | PO BOX 71325 |
Mailing Address - Street 2: | SUITE 259 |
Mailing Address - City: | SAN JUAN |
Mailing Address - State: | PR |
Mailing Address - Zip Code: | 00936 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 787-486-3225 |
Mailing Address - Fax: | 787-620-4884 |
Practice Address - Street 1: | AVE. 65 INF. KM 2.0 |
Practice Address - Street 2: | OFICINA 23 |
Practice Address - City: | SAN JUAN |
Practice Address - State: | PR |
Practice Address - Zip Code: | 00924 |
Practice Address - Country: | US |
Practice Address - Phone: | 787-486-3225 |
Practice Address - Fax: | 787-486-3225 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-05-22 |
Last Update Date: | 2009-05-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PR | TC AMB 373 | 3416L0300X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 3416L0300X | Transportation Services | Ambulance | Land Transport |