Healthcare Provider Details

I. General information

NPI: 1639590375
Provider Name (Legal Business Name): RESPONSE TIME AMBULANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2013
Last Update Date: 03/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 EASTERN PKWY
JERSEY CITY NJ
07305-4011
US

IV. Provider business mailing address

17 EASTERN PKWY
JERSEY CITY NJ
07305-4011
US

V. Phone/Fax

Practice location:
  • Phone: 973-303-9265
  • Fax:
Mailing address:
  • Phone: 973-303-9265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. MICHAEL JORDAN FLORES
Title or Position: CEO / OWNER
Credential: A.A.S., NREMT
Phone: 973-303-9265