Organization
D & V LLC
Active
Other names
Life Line Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DMITRIY DOROTOV (OWNER)
(215) 464-5433
Entity
Organization
Contact information
Practice address
9998 GLOBAL RD, SUITE #37, PHILADELPHIA, PA 19115-1010
(215) 464-5433
(215) 464-2610
Mailing address
9998 GLOBAL RD, SUITE #37, PHILADELPHIA, PA 19115-1010
(215) 464-5433
(215) 464-2610
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
04088
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007162000
IBC
PA
05
—
1011524760001
—
PA
01
—
30019372
KEYSTONE MERCY
PA
01
—
35138
SENIOR PARTNERS
PA
01
—
3699772
AETNA
PA
01
—
52857
ELDER HEALTH
PA
01
—
8100459
EVERCARE
PA
01
—
P00228042
MEDICARE RAIL ROAD
PA
01
—
Q54652
ICHP
PA
Enumeration date
02/28/2007
Last updated
04/20/2008
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