1003811274 NPI number — CJ CRITICAL CARE TRANSPORTATION SYSTEMS, INC.

Table of content: (NPI 1003811274)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003811274 NPI number — CJ CRITICAL CARE TRANSPORTATION SYSTEMS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CJ CRITICAL CARE TRANSPORTATION SYSTEMS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003811274
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
275 CURRY HOLLOW RD
Provider Second Line Business Mailing Address:
STE G300
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15236-4631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-653-2185
Provider Business Mailing Address Fax Number:
412-653-6050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
57 ALLEGHENY COUNTY AIRPORT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15122-2674
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-660-1605
Provider Business Practice Location Address Fax Number:
412-653-6050
Provider Enumeration Date:
06/15/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KEENE
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
NATIONAL DIRECTOR
Authorized Official Telephone Number:
909-915-2301

Provider Taxonomy Codes

  • Taxonomy code: 3416A0800X , with the licence number:  1156 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0638206 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3406931 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".