Provider Demographics
NPI:1578284469
Name:JCL AMBULANCE CORP
Entity Type:Organization
Organization Name:JCL AMBULANCE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICEPRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:RIVERA PENA
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:787-488-0289
Mailing Address - Street 1:41 CALLE MUNOZ RIVERA UNIT 550
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-1699
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CARR 770 KM 1.3 INT BO PALO HINCADO SECTOR LA TORRE
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794
Practice Address - Country:US
Practice Address - Phone:787-636-7771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance