| Organization Name: | LIFE RESCUE AMBULANCE INC |
| NPI Number: | 1306104088 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | IVAN GUDIMOV (OWNER /PRESIDENT) |
| Mailing Address: | 2002 Grant Ave Philadelphia |
| State: | PA US |
| Postal Code: | 191154355 |
| Phone Number: | 2156682999 |
| Fax Number: | |
| NPI Enumeration Date: | 05/01/2012 |
| NPI Last Update Date: | 05/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 341600000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane). |