Provider Demographics
NPI:1932400389
Name:MED RESPONCE
Entity Type:Organization
Organization Name:MED RESPONCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARSENIY
Authorized Official - Middle Name:
Authorized Official - Last Name:POLUTSKHORADZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-344-8348
Mailing Address - Street 1:3103 PHILMONT AVE
Mailing Address - Street 2:SUITE 348
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-4263
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3103 PHILMONT AVE
Practice Address - Street 2:SUITE 348
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-4263
Practice Address - Country:US
Practice Address - Phone:215-344-8348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance