NPIMap

Organization Active NPI

Life Rescue Ambulance Inc

  • Ambulance
  • Philadelphia, PA
National Provider Identifier
1306104088
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
LIFE RESCUE AMBULANCE INC
Practice address
2002 Grant Ave
Philadelphia, PA 19115-4355
Phone
(215) 668-2999
NPI assigned
May 1, 2012
Last updated
May 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ivan Gudimov
Title
Owner /President
Phone
(215) 668-2999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X Primary

Addresses

Primary practice location

2002 Grant Ave
Philadelphia, PA 19115-4355

Mailing address

2002 Grant Ave
Philadelphia, PA 19115
Phone (215) 668-2999

National Provider Directory

National Provider Directory

Locations

2002 Grant Ave
Philadelphia, PA 19115
Phone (215) 668-2999

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335830400000",
    "number": "1306104088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 GRANT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19115",
            "telephone_number": "215-668-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 GRANT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154355",
            "telephone_number": "215-668-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE RESCUE AMBULANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-01",
        "last_updated": "2012-05-01",
        "status": "A",
        "authorized_official_last_name": "GUDIMOV",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "OWNER /PRESIDENT",
        "authorized_official_telephone_number": "215-668-2999"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.