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General NPI Number Information
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NPI Number | 1053756536
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Entity Type | Organization
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Legal Business Name | SAMARITIAN EMS AMBULANCE
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Dates
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Enumeration Date | 05/09/2013
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Last Update Date | 05/09/2013
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Provider Practice Location Address
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Address Line | 10065 SANDMEYER LN SUITE 301
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City | PHILADELPHIA
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State | PA
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Zip | 19116-3515
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Country | US
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Telephone | 303-669-0861
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Fax |
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Provider Business Mailing Address
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Address Line | 10065 SANDMEYER LN SUITE 301
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City | PHILADELPHIA
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State | PA
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Zip | 19116-3528
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Country | US
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Telephone | 303-669-0861
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIMUR RAMIZOV
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Credential |
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Telephone | 303-669-0861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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