MEDICARE: METRO AMBULANCE AND TRANSPORTATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	10006	PA

General Provider Information

NPI Number	:	1700102266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METRO AMBULANCE AND TRANSPORTATION

Provider Business Mailing Address
First Line	:	6301 GERMANTOWN AVE
Second Line	:	STE 2
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-1907
Country	:	US
Telephone Number	:	215-991-9191
Fax Number	:

Provider Business Practice Location Address
First Line	:	6301 GERMANTOWN AVE
Second Line	:	STE 2
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-1907
Country	:	US
Telephone Number	:	215-991-9191
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALLA KHUTORYANSKY
Credential	:
Telephone Number	:	215-991-9191

Provider Enumeration Date	:	04/08/2010
Last Update Date	:	01/11/2013

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