# EDGAR C RODRIGUEZ HEREDIA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GLORIED AMBULANCE SERVICE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114096047
- **Authorized official:** EDGAR RODRIGUEZ (PRESIDENT)
- **Authorized official phone:** (787) 262-0501

## Contact information

- **Practice address:** C20 CALLE 4, URB DEL CARMEN, CAMUY, PR 00627-2843
- **Practice address phone:** (787) 262-0501
- **Mailing address:** PO BOX 566, CAMUY, PR 00627-0566

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | TC-AMB208 | PR | Yes |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 06/26/2008