Premium Response LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

PREMIUM RESPONSE LLC

Practice address

380 Red Lion Rd Ste 231
Huntingdon Valley, PA 19006-6451

Phone

(425) 350-7678

NPI assigned

Jul 2, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Vitaliy Didok

Title

Owner

Phone

(425) 350-7678

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1902642614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 LACEBARK ST",
            "city": "FEASTERVILLE TREVOSE",
            "state": "PA",
            "postal_code": "190534515",
            "telephone_number": "425-350-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 RED LION RD STE 231",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190066451",
            "telephone_number": "425-350-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM RESPONSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "DIDOK",
        "authorized_official_first_name": "VITALIY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-350-7678",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Huntingdon Valley, PA
• Providers in Huntingdon Valley, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.