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General NPI Number Information
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NPI Number | 1679018246
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Entity Type | Organization
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Legal Business Name | AMBU-LINK LLC
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Dates
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Enumeration Date | 01/05/2017
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Last Update Date | 03/28/2019
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Provider Practice Location Address
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Address Line | 2088 IDLEWOOD RD STE 5
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City | TUCKER
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State | GA
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Zip | 30084-6264
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Country | US
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Telephone | 612-516-6567
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 663
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City | STONE MOUNTAIN
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State | GA
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Zip | 30086-0663
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Country | US
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Telephone | 612-516-6567
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YUSSUF JAMAA
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Credential |
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Telephone | 612-516-6567
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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 | AMB2016020
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License Number State | GA
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