1457623159 NPI number — J.E.T. RESPONSE LLC

Table of content: (NPI 1457623159)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457623159 NPI number — J.E.T. RESPONSE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
J.E.T. RESPONSE LLC
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:
1457623159
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
892 NEW CASTLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SLIPPERY ROCK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16057-4228
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-280-5974
Provider Business Mailing Address Fax Number:
724-234-4703

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 AYERS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEMOYNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17043-1710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-462-0365
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/27/2012

Additional Information

Authorized Official

Authorized Official Last Name:
FRONK
Authorized Official First Name:
ELIZABETH
Authorized Official Middle Name:
LORRAINE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
717-462-0365

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: P01559366 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 248475 . This is a "MEDICARE PTAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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