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General NPI Number Information
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NPI Number | 1770104879
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Entity Type | Organization
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Legal Business Name | J&P MEDICAL TRANSPORT, LLC
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Dates
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Enumeration Date | 04/29/2020
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Last Update Date | 05/19/2020
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Provider Practice Location Address
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Address Line | 6073 N FRESNO ST STE 105
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City | FRESNO
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State | CA
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Zip | 93710-8614
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Country | US
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Telephone | 682-433-9287
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Fax |
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Provider Business Mailing Address
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Address Line | 6073 N FRESNO ST STE 105
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City | FRESNO
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State | CA
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Zip | 93710-8614
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | DR. JUSTICE OTCHERE
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Credential | MD
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Telephone | 682-433-9287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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