# BLUE STAR AMBULANCE LLC

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

## Provider details

- **NPI number:** 1386340206
- **Authorized official:** MAGALY PACHECO (PRESIDENT)
- **Authorized official phone:** (787) 202-2845

## Contact information

- **Practice address:** CARR 511 KM 0.6 BO. REAL ANON, COTO LAUREL, PR 00780
- **Practice address phone:** (787) 901-8334
- **Practice address fax:** (787) 936-7428
- **Mailing address:** PO BOX 800481, COTO LAUREL, PR 00780-0481
- **Mailing address phone:** (787) 901-8334

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 02/02/2023
- **Last updated:** 09/11/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | PR | CSP | PR |