Provider Demographics
NPI:1871801241
Name:XAVIER AMBULANCE
Entity type:Organization
Organization Name:XAVIER AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDGARDO
Authorized Official - Middle Name:J
Authorized Official - Last Name:JIRAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-939-6781
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:RD 111 INT 602
Mailing Address - City:ANGELES
Mailing Address - State:PR
Mailing Address - Zip Code:00611-0099
Mailing Address - Country:US
Mailing Address - Phone:787-933-6781
Mailing Address - Fax:787-933-6781
Practice Address - Street 1:111 RD 602 INT
Practice Address - Street 2:
Practice Address - City:ANGELES
Practice Address - State:PR
Practice Address - Zip Code:00611
Practice Address - Country:US
Practice Address - Phone:787-933-6781
Practice Address - Fax:787-933-6781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB-559341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance