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General NPI Number Information
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NPI Number | 1922464536
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Entity Type | Organization
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Legal Business Name | RESCUE AMBULANCE SERVICE, LLC
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Dates
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Enumeration Date | 01/12/2016
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Last Update Date | 11/24/2024
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Provider Practice Location Address
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Address Line | 2166 W PARK CT STE B
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-3546
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Country | US
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Telephone | 470-819-4151
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Fax | 470-679-3052
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Provider Business Mailing Address
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Address Line | 2166 W PARK CT STE B
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-3546
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Country | US
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Telephone | 470-819-4151
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Fax | 470-679-3052
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | JAMAL ABDI ALI
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Credential |
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Telephone | 404-732-6240
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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 | 031-31
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License Number State | GA
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