Provider Demographics
NPI:1154938918
Name:CENTRAL MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:CENTRAL MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:R
Authorized Official - Last Name:REPOLLET
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:787-319-9380
Mailing Address - Street 1:HC 1 BOX 5981
Mailing Address - Street 2:
Mailing Address - City:CIALES
Mailing Address - State:PR
Mailing Address - Zip Code:00638-9699
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CARR 157 KM 6.7 BO CACAO
Practice Address - Street 2:SECTOR LA ALTURITA
Practice Address - City:OROCOVIS
Practice Address - State:PR
Practice Address - Zip Code:00720
Practice Address - Country:US
Practice Address - Phone:787-319-9380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
123456789OtherSERVICIO DE AMBULANCIA