1205258530 NPI number — ELDERLY TRANSPORTATION SERVICES MANAGEMENT LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205258530 NPI number — ELDERLY TRANSPORTATION SERVICES MANAGEMENT LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ELDERLY TRANSPORTATION SERVICES MANAGEMENT LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205258530
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BOX 2000 CARR 8177
Provider Second Line Business Mailing Address:
SUITE 26 PMB 218
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00966-3762
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-771-6900
Provider Business Mailing Address Fax Number:
787-771-6901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 199 EDIF ALB PLAZA SUITE #16
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00969
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-771-6900
Provider Business Practice Location Address Fax Number:
787-771-6901
Provider Enumeration Date:
01/06/2014

Additional Information

Authorized Official

Authorized Official Last Name:
RUIZ
Authorized Official First Name:
JORGE
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
787-771-6900

Provider Taxonomy Codes

  • Taxonomy code: 347E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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