# PRIMARY LIFE SUPPORT CORP.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124354923
- **Authorized official:** JOEL AROCHO MOLINA (PRESIDENTE)
- **Authorized official phone:** (787) 629-9973

## Contact information

- **Practice address:** CARR 4417 KM 0.6 INTERIOR, BO MAMEY, AGUADA, PR 00602
- **Practice address phone:** (787) 629-9973
- **Mailing address:** P O BOX 1291, AGUADA, PR 00602
- **Mailing address phone:** (787) 629-9973

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | CP-4739 | PR | Yes |

## Other

- **Enumeration date:** 10/29/2009
- **Last updated:** 10/29/2009