Provider Demographics
NPI:1316409923
Name:JT ENTERPRISES, INC DBA PROMED TRANSPORTATION
Entity type:Organization
Organization Name:JT ENTERPRISES, INC DBA PROMED TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:TARNOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-390-9395
Mailing Address - Street 1:6588 FREDENBERG LAKE RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55803-9468
Mailing Address - Country:US
Mailing Address - Phone:218-390-9395
Mailing Address - Fax:
Practice Address - Street 1:6588 FREDENBERG LAKE RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55803-9468
Practice Address - Country:US
Practice Address - Phone:218-390-9395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)