Provider Demographics
NPI:1730238114
Name:NORTHWEST AMBULANCE SERVICES
Entity type:Organization
Organization Name:NORTHWEST AMBULANCE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECT OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUISA
Authorized Official - Middle Name:I
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-796-1565
Mailing Address - Street 1:72 CALLE POMAROSAS
Mailing Address - Street 2:MONTE ELENA
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-5602
Mailing Address - Country:US
Mailing Address - Phone:787-796-1565
Mailing Address - Fax:
Practice Address - Street 1:72 CALLE POMAROSAS
Practice Address - Street 2:MONTE ELENA
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-5602
Practice Address - Country:US
Practice Address - Phone:787-796-1565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2009-07-01
Deactivation Date:2008-08-07
Deactivation Code:
Reactivation Date:2009-07-01
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB4373416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport