Provider Demographics
NPI:1295082410
Name:RESCUE TEAM AMBULANCE INC
Entity type:Organization
Organization Name:RESCUE TEAM AMBULANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIRILL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOICHENKO
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:215-268-6173
Mailing Address - Street 1:3021 FRANKS RD STE 2
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-4216
Mailing Address - Country:US
Mailing Address - Phone:215-268-6173
Mailing Address - Fax:215-938-0707
Practice Address - Street 1:3021 FRANKS ROAD
Practice Address - Street 2:SUITE 2
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006
Practice Address - Country:US
Practice Address - Phone:215-268-6173
Practice Address - Fax:215-938-0707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA12037341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance