Provider Demographics
NPI:1922464536
Name:RESCUE AMBULANCE SERVICE, LLC
Entity Type:Organization
Organization Name:RESCUE AMBULANCE SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMAL
Authorized Official - Middle Name:ABDI
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-732-6240
Mailing Address - Street 1:526 FOREST PKWY
Mailing Address - Street 2:SUITE D
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30297-6140
Mailing Address - Country:US
Mailing Address - Phone:470-819-4151
Mailing Address - Fax:470-823-3125
Practice Address - Street 1:526 FOREST PKWY
Practice Address - Street 2:SUITE D
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-6140
Practice Address - Country:US
Practice Address - Phone:470-819-4151
Practice Address - Fax:470-823-3125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031-313416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport