Provider Demographics
NPI:1801040928
Name:JIRAU AMBULANCE SERVICE CORP.
Entity Type:Organization
Organization Name:JIRAU AMBULANCE SERVICE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDGARDO
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:JIRAU SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-933-6781
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:ANGELES
Mailing Address - State:PR
Mailing Address - Zip Code:00611-0099
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CARR 111 INT 602
Practice Address - Street 2:
Practice Address - City:ANGELES
Practice Address - State:PR
Practice Address - Zip Code:00611-0099
Practice Address - Country:US
Practice Address - Phone:787-933-6781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR559341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance