Provider Demographics
NPI:1487312542
Name:VITAL CARE AMBULANCE LLC
Entity type:Organization
Organization Name:VITAL CARE AMBULANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:GLORIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-529-4504
Mailing Address - Street 1:URB PUERTO NUEVO
Mailing Address - Street 2:405 CALLE ARAGON
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-4121
Mailing Address - Country:US
Mailing Address - Phone:787-529-4504
Mailing Address - Fax:
Practice Address - Street 1:URB RIO PIEDRAS HTS
Practice Address - Street 2:1695 CALLE PARANA SUITE 4
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-3143
Practice Address - Country:US
Practice Address - Phone:787-529-4504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport