Healthcare Provider Details

I. General information

NPI: 1215672365
Provider Name (Legal Business Name): PATIENCE MEDICAL TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 GLENSIDE DR
WEST ORANGE NJ
07052-4709
US

IV. Provider business mailing address

20 GLENSIDE DR
WEST ORANGE NJ
07052-4709
US

V. Phone/Fax

Practice location:
  • Phone: 201-396-0417
  • Fax: 973-419-0414
Mailing address:
  • Phone: 973-991-9829
  • Fax: 973-419-0414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: REAGEN PIERRE
Title or Position: OWNER
Credential:
Phone: 201-396-0417