Healthcare Provider Details

I. General information

NPI: 1831284827
Provider Name (Legal Business Name): QUICK RESPONSE SERVICE MEDICAL TRAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 05/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 E FRONT ST
MEDIA PA
19063-2911
US

IV. Provider business mailing address

41 E FRONT ST
MEDIA PA
19063-2911
US

V. Phone/Fax

Practice location:
  • Phone: 215-368-7350
  • Fax: 215-368-7353
Mailing address:
  • Phone: 215-368-7350
  • Fax: 215-368-7353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number06127
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number06127
License Number StatePA

VIII. Authorized Official

Name: TIMOTHY CAVANAUGH
Title or Position: PRESIDENT
Credential:
Phone: 610-924-4795