Provider Demographics
NPI:1679132856
Name:REGIONAL EMERGENCY SUPPORT QUICK RESPONSE SERVICE LLC
Entity Type:Organization
Organization Name:REGIONAL EMERGENCY SUPPORT QUICK RESPONSE SERVICE LLC
Other - Org Name:RESQRS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COBERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-859-7377
Mailing Address - Street 1:892 NEW CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-4228
Mailing Address - Country:US
Mailing Address - Phone:800-240-6365
Mailing Address - Fax:
Practice Address - Street 1:1324 STATE ROUTE 168
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:PA
Practice Address - Zip Code:15043
Practice Address - Country:US
Practice Address - Phone:124-859-7377
Practice Address - Fax:724-234-4703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-11
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1036714040001Medicaid