Provider Demographics
NPI:1306285622
Name:GOLDENAGETRANSPORTATIONSERVICES,INC
Entity type:Organization
Organization Name:GOLDENAGETRANSPORTATIONSERVICES,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-282-6200
Mailing Address - Street 1:1404AVEPAZGRANDELA
Mailing Address - Street 2:PMB510SUITE2
Mailing Address - City:SANJUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-4131
Mailing Address - Country:US
Mailing Address - Phone:787-282-6200
Mailing Address - Fax:787-282-6201
Practice Address - Street 1:CARR199EDIFALBPLAZA
Practice Address - Street 2:SUITE16
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-282-6200
Practice Address - Fax:787-282-6201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRPCVTI-4666343900000X
PRPCVTE-4665344600000X
PRPVVTI-4666343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi