Provider Demographics
NPI:1932427416
Name:PROMEDIC HEALTH CARE AMBULANCE, CORP
Entity type:Organization
Organization Name:PROMEDIC HEALTH CARE AMBULANCE, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:MELENDEZ
Authorized Official - Last Name:PAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:787-212-4871
Mailing Address - Street 1:PO BOX 1435
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-1435
Mailing Address - Country:US
Mailing Address - Phone:787-733-1458
Mailing Address - Fax:787-733-1458
Practice Address - Street 1:#66 C-37 CARRION STREET
Practice Address - Street 2:URB. COLINAS SAN AGUSTIN
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771
Practice Address - Country:US
Practice Address - Phone:787-733-1458
Practice Address - Fax:787-733-1458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2356 PARAMEDIC3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport