Provider Demographics
NPI:1316693872
Name:CRITICAL HEALTH AMBULANCE CORP
Entity type:Organization
Organization Name:CRITICAL HEALTH AMBULANCE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MENDEZ FRONTERAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-313-6498
Mailing Address - Street 1:HC 8 BOX 24426
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-9644
Mailing Address - Country:US
Mailing Address - Phone:787-313-6498
Mailing Address - Fax:787-551-7104
Practice Address - Street 1:CARR 4110 KM 0.3
Practice Address - Street 2:BO CAIMITAL BAJO
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-313-6498
Practice Address - Fax:787-551-7104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-23
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRTCAMB-135556OtherTCAMB