A Vital Response Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

06006 Issued in PA

Legal business name

A VITAL RESPONSE INC.

Practice address

1205 S 28TH St
Harrisburg, PA 17111-1046

Phone

(717) 207-7780

Fax

(717) 754-0011

NPI assigned

Jun 25, 2006

Organization subpart

No

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

Authorized official

Name

Timothy M Moench

Title

Chief of Operations

Phone

(717) 207-7780

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1942236344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 S 28TH ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171111046",
            "telephone_number": "717-207-7780",
            "fax_number": "717-754-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 S 28TH ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171111046",
            "telephone_number": "717-207-7780",
            "fax_number": "717-754-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A VITAL RESPONSE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "MOENCH",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF OF OPERATIONS",
        "authorized_official_telephone_number": "717-207-7780"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "06006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD PA",
            "identifier": "001860315",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101535548",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDANCE BLUE CROSS",
            "identifier": "0009029000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.