Provider Demographics
NPI:1700102266
Name:METRO AMBULANCE AND TRANSPORTATION
Entity type:Organization
Organization Name:METRO AMBULANCE AND TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHUTORYANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-991-9191
Mailing Address - Street 1:6301 GERMANTOWN AVE
Mailing Address - Street 2:STE 2
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-1907
Mailing Address - Country:US
Mailing Address - Phone:215-991-9191
Mailing Address - Fax:
Practice Address - Street 1:6301 GERMANTOWN AVE
Practice Address - Street 2:STE 2
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-1907
Practice Address - Country:US
Practice Address - Phone:215-991-9191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA100063416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport