Provider Demographics
NPI:1346560612
Name:MEDRESCUE AMBULANCE INC.
Entity Type:Organization
Organization Name:MEDRESCUE AMBULANCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STANISLAV
Authorized Official - Middle Name:
Authorized Official - Last Name:ENTUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-500-9993
Mailing Address - Street 1:3021 FRANKS RD
Mailing Address - Street 2:UNIT C
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-4216
Mailing Address - Country:US
Mailing Address - Phone:215-285-1978
Mailing Address - Fax:
Practice Address - Street 1:3021 FRANKS RD
Practice Address - Street 2:UNIT C
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-4216
Practice Address - Country:US
Practice Address - Phone:215-285-1978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-09
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance