Provider Demographics
NPI:1073372793
Name:ADVANCED LIFE SERVICES INC
Entity Type:Organization
Organization Name:ADVANCED LIFE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RAKHMANOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-302-5116
Mailing Address - Street 1:298A WASHINGTON PLACE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559
Mailing Address - Country:US
Mailing Address - Phone:929-383-4606
Mailing Address - Fax:516-537-0175
Practice Address - Street 1:298A WASHINGTON PLACE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559
Practice Address - Country:US
Practice Address - Phone:929-383-4606
Practice Address - Fax:516-537-0175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies