Provider Demographics
NPI:1245190271
Name:PINK JELLY PARAMEDICAL SERVICES, LLC
Entity type:Organization
Organization Name:PINK JELLY PARAMEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDMOND JOHN
Authorized Official - Middle Name:BALATBAT
Authorized Official - Last Name:MEJIA-VENTURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:183-366-0746
Mailing Address - Street 1:1201 N 3RD ST # 178
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-4425
Mailing Address - Country:US
Mailing Address - Phone:833-660-7465
Mailing Address - Fax:312-600-4447
Practice Address - Street 1:7 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1578
Practice Address - Country:US
Practice Address - Phone:833-660-7465
Practice Address - Fax:312-600-4447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-13
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty