MEDICARE: LIFE LINC HABACO, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285675041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE LINC HABACO, INC

Provider Business Mailing Address
First Line	:	1228 VILLAGE WAY
Second Line	:	SUITE N
City	:	SANTA ANA
State	:	CA
Zip	:	92705-4747
Country	:	US
Telephone Number	:	714-480-1562
Fax Number	:	714-480-1566

Provider Business Practice Location Address
First Line	:	1228 VILLAGE WAY
Second Line	:	SUITE N
City	:	SANTA ANA
State	:	CA
Zip	:	92705-4747
Country	:	US
Telephone Number	:	714-480-1562
Fax Number	:	714-480-1566

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MURRAY ALLEN ROBINSON
Credential	:
Telephone Number	:	800-521-2106

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	08/22/2020

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