Provider Demographics
NPI:1972912020
Name:DIRECT EMERGENCY MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:DIRECT EMERGENCY MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RONDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-373-5164
Mailing Address - Street 1:440 MARKET ST
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-2618
Mailing Address - Country:US
Mailing Address - Phone:201-773-9393
Mailing Address - Fax:201-773-9394
Practice Address - Street 1:440 MARKET ST
Practice Address - Street 2:SUITE 4B
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-2618
Practice Address - Country:US
Practice Address - Phone:201-773-9393
Practice Address - Fax:201-773-9394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-03
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1006993416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport