Healthcare Provider Details

I. General information

NPI: 1558088609
Provider Name (Legal Business Name): ACUTE RESPONSE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2022
Last Update Date: 07/19/2023
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4311 SARA RD SE STE 100
RIO RANCHO NM
87124-1524
US

IV. Provider business mailing address

4445 EASTGATE MALL STE 200
SAN DIEGO CA
92121-1979
US

V. Phone/Fax

Practice location:
  • Phone: 619-254-0547
  • Fax:
Mailing address:
  • Phone: 619-254-0547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: EDWARD LIDALE JONES
Title or Position: CEO
Credential:
Phone: 442-515-3395