# JERUSALEN HOME AMBULANCE, INC.

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

## Provider details

- **NPI number:** 1275541500
- **Authorized official:** MR. LUIS ORTIZ (DIRECTOR)
- **Authorized official phone:** (787) 653-2225

## Contact information

- **Practice address:** AVE LUIS MUNOZ MARIN ESQUINA GEORGETTI, ANGORA PARK PLAZA, CAGUAS, PR 00725
- **Practice address phone:** (787) 653-1717
- **Practice address fax:** (787) 653-1720
- **Mailing address:** PO BOX 1780, CAGUAS, PR 00726-1780
- **Mailing address phone:** (787) 653-2225
- **Mailing address fax:** (787) 653-1720

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | TCAMB-164 | PR | — |
| 3416L0300X | Land Ambulance | TCAMB-361 | PR | Yes |

## Other

- **Enumeration date:** 08/03/2006
- **Last updated:** 02/21/2014