Jac Medi Transport LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

JAC MEDI TRANSPORT LLC

Practice address

11 Tomasello Dr
Millville, NJ 08332-9422

Phone

(732) 939-7901

NPI assigned

Jul 24, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. John Colalillo

Title

Owner

Phone

(732) 939-7901

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532390400000",
    "number": "1861979759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 TOMASELLO DR",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083329422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 TOMASELLO DR",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083329422",
            "telephone_number": "732-939-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAC MEDI TRANSPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A",
        "authorized_official_last_name": "COLALILLO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-939-7901",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343900000X",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Millville, NJ
• Providers in Millville, NJ by specialty
• Non-emergency Medical Transport (VAN) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.