Organization
LIFEGUARD AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FLORENCE BANIN (ADMINSTRATIVE ASSISTANT)
(215) 852-2413
Entity
Organization
Contact information
Practice address
10000C JEANES STREET, 2ND FLOOR, PHILADELPHIA, PA 19116
(215) 852-2413
Mailing address
PO BOX 52087, PHILADELPHIA, PA 19115-7087
(215) 852-2413
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076388
MEDICARE PROVIDER ID
PA
Enumeration date
06/12/2009
Last updated
06/12/2009
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