Provider Demographics
NPI:1164578100
Name:RESPONSIVE MEDICAL LLC
Entity Type:Organization
Organization Name:RESPONSIVE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-743-8959
Mailing Address - Street 1:1613 BRITTON DR
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-2000
Mailing Address - Country:US
Mailing Address - Phone:219-743-8959
Mailing Address - Fax:
Practice Address - Street 1:900 20TH AVE SW
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-6445
Practice Address - Country:US
Practice Address - Phone:219-743-8959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND028842OtherBLUE CROSS AND BLUE SHIEL
ND028842OtherBLUE CROSS AND BLUE SHIEL
5871800001Medicare PIN
5871800001Medicare Oscar/Certification
ND028842OtherBLUE CROSS AND BLUE SHIEL