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General NPI Number Information
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NPI Number | 1942236344
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Entity Type | Organization
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Legal Business Name | A VITAL RESPONSE INC.
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 1205 S 28TH ST
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City | HARRISBURG
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State | PA
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Zip | 17111-1046
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Country | US
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Telephone | 717-207-7780
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Fax | 717-754-0011
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Provider Business Mailing Address
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Address Line | 1205 S 28TH ST
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City | HARRISBURG
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State | PA
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Zip | 17111-1046
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Country | US
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Telephone | 717-207-7780
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Fax | 717-754-0011
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Authorized Official
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Title or Position | CHIEF OF OPERATIONS
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Name | TIMOTHY M MOENCH
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Credential |
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Telephone | 717-207-7780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 06006
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License Number State | PA
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