Provider Demographics
NPI:1558610030
Name:GUARD WELL MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:GUARD WELL MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-289-8837
Mailing Address - Street 1:56 PATERSON ST FL 2
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-3422
Mailing Address - Country:US
Mailing Address - Phone:973-289-8837
Mailing Address - Fax:888-908-2749
Practice Address - Street 1:56 PATERSON ST FL 2
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-3422
Practice Address - Country:US
Practice Address - Phone:973-289-8837
Practice Address - Fax:888-908-2749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0912021341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance