Organization
LONG LIFE AMBULANCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSTAM USMANOV (C.E.O)
(267) 574-4208
Entity
Organization
Contact information
Practice address
10065 SANDMEYER LANE, 103, PHILADELPHIA, PA 19116
(215) 660-4882
Mailing address
10065 SANDMEYER LANE, 103, PHILADELPHIA, PA 19116
(215) 660-4882
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Enumeration date
04/15/2011
Last updated
02/21/2012
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