Provider Demographics
NPI:1922283753
Name:BASCO AMBULANCE INC
Entity Type:Organization
Organization Name:BASCO AMBULANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ERNESTO
Authorized Official - Last Name:BASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-857-2876
Mailing Address - Street 1:HC 4 BOX 5847
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-9411
Mailing Address - Country:US
Mailing Address - Phone:787-857-2876
Mailing Address - Fax:787-857-4539
Practice Address - Street 1:CARR152 KM 1.6 INT BO QUEBRADA GRANDE
Practice Address - Street 2:SECTOR TRES CAMINOS
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794
Practice Address - Country:US
Practice Address - Phone:787-857-2876
Practice Address - Fax:787-857-4539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3112-CP341600000X
PR3113-CP341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance