Provider Demographics
NPI:1306130935
Name:PEDIATRIC & ADULT MEDICAL SERVICE, AMBULANCE INC
Entity type:Organization
Organization Name:PEDIATRIC & ADULT MEDICAL SERVICE, AMBULANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REPRESENTATIVE
Authorized Official - Prefix:MR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:JUAN
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:787-671-9952
Mailing Address - Street 1:PO BOX 2367
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-2367
Mailing Address - Country:US
Mailing Address - Phone:787-671-9952
Mailing Address - Fax:787-762-5161
Practice Address - Street 1:CALLE 20 R 1 CIUDAD UNIVERSITARIA
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-671-9952
Practice Address - Fax:787-762-5161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR25796963416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport