=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841535366
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JONEL ENTERPRISES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/10/2012
-----------------------------------------------------
Last Update Date | 12/10/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2530 SARATOGA CT
-----------------------------------------------------
City | PALMDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93551-4609
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-947-8981
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 38713 TIERRA SUBIDA AVE STE 200 PMB 242
-----------------------------------------------------
City | PALMDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93551-4562
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-947-8981
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER / OPERATOR
-----------------------------------------------------
Name | MR. JOHN TIMOTHY CURTIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 661-947-8981
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------