Organization
MEDALLIANCE AMBULANCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKAEL M TEMIROV EMT (OWNER)
(215) 753-5984
Entity
Organization
Contact information
Practice address
11880 BUSTLETON AVE, SUITE 206, PHILADELPHIA, PA 19116
(215) 792-6329
Mailing address
11880 BUSTLETON AVE, SUITE 206, PHILADELPHIA, PA 19116-2538
(215) 792-6329
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
156261
PA
Other
Enumeration date
12/20/2011
Last updated
01/04/2013
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