Provider Demographics
NPI:1366981110
Name:UNITED MOBILE RESPONSE LLC
Entity type:Organization
Organization Name:UNITED MOBILE RESPONSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-361-4305
Mailing Address - Street 1:14506 PRAIRIE AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-8349
Mailing Address - Country:US
Mailing Address - Phone:424-361-4305
Mailing Address - Fax:310-943-3576
Practice Address - Street 1:14506 PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-8349
Practice Address - Country:US
Practice Address - Phone:424-361-4305
Practice Address - Fax:310-943-3576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2018-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA3366376343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)