Provider Demographics
NPI:1730309030
Name:FIRST CLASS AMBULANCE INC
Entity Type:Organization
Organization Name:FIRST CLASS AMBULANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPIETARIA/PRESIDENTA
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTALVO ACEVEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-236-5291
Mailing Address - Street 1:RR 1 BOX 37154
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-9101
Mailing Address - Country:US
Mailing Address - Phone:787-236-5291
Mailing Address - Fax:
Practice Address - Street 1:RD 354 KM 7.5 SECTOR LA VIOLETA
Practice Address - Street 2:BO LEGUIZAMO
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-638-8941
Practice Address - Fax:787-818-0429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 4643416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR50802OtherPMC
PR0058891Medicare PIN