Provider Demographics
NPI:1568862746
Name:PARITEE, JARROD
Entity Type:Individual
Prefix:
First Name:JARROD
Middle Name:
Last Name:PARITEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10694 E OUTER DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-2964
Mailing Address - Country:US
Mailing Address - Phone:248-797-6823
Mailing Address - Fax:313-469-9723
Practice Address - Street 1:10694 E OUTER DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-2964
Practice Address - Country:US
Practice Address - Phone:248-797-6823
Practice Address - Fax:313-469-9723
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL10223343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)