Provider Demographics
NPI:1902345143
Name:ACTIVE AID SOLUTIONS, LLC
Entity Type:Organization
Organization Name:ACTIVE AID SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:IREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOROSHOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-991-0188
Mailing Address - Street 1:268 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-6735
Mailing Address - Country:US
Mailing Address - Phone:267-991-0188
Mailing Address - Fax:888-993-5099
Practice Address - Street 1:268 S 11TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6735
Practice Address - Country:US
Practice Address - Phone:267-991-0188
Practice Address - Fax:888-993-5099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA44984333300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies