Provider Demographics
NPI:1689614455
Name:HEALTHCARE AMBULATORY SERVICES, INC
Entity Type:Organization
Organization Name:HEALTHCARE AMBULATORY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIVERA-ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-286-6060
Mailing Address - Street 1:PO BOX 193477
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-3477
Mailing Address - Country:US
Mailing Address - Phone:787-728-3030
Mailing Address - Fax:787-728-7050
Practice Address - Street 1:CARR 172 PLAZA DEL CARMEN MALL LOCAL 24
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-9999
Practice Address - Country:US
Practice Address - Phone:787-286-6060
Practice Address - Fax:787-286-6161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QE0002X, 261QR0200X
PR1056291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No291U00000XLaboratoriesClinical Medical Laboratory