Organization
LIFE RESCUE AMBULANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN GUDIMOV (OWNER /PRESIDENT)
(215) 668-2999
Entity
Organization
Contact information
Practice address
2002 GRANT AVE, PHILADELPHIA, PA 19115-4355
(215) 668-2999
Mailing address
2002 GRANT AVE, PHILADELPHIA, PA 19115
(215) 668-2999
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Enumeration date
05/01/2012
Last updated
05/01/2012
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