Healthcare Provider Details

I. General information

NPI: 1285951582
Provider Name (Legal Business Name): RAPID PATIENT MOBILIZATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2010
Last Update Date: 10/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1852 ABA DR
ORANGE PARK FL
32073-2782
US

IV. Provider business mailing address

1852 ABA DR
ORANGE PARK FL
32073-2782
US

V. Phone/Fax

Practice location:
  • Phone: 904-269-1397
  • Fax:
Mailing address:
  • Phone: 904-269-1397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberALS 1612
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. SHAWN JERE PELLETIER
Title or Position: PRESIDENT / CEO
Credential: PMD
Phone: 904-269-1397