MEDICARE: LIFENET HEALTH

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	335U00000X	Organ Procurement Organization		VA
2	332B00000X	Durable Medical Equipment & Medical Supplies		VA

General Provider Information

NPI Number	:	1295199156
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFENET HEALTH

Provider Business Mailing Address
First Line	:	1864 CONCERT DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23453-1903
Country	:	US
Telephone Number	:	757-609-4602
Fax Number	:	757-609-5721

Provider Business Practice Location Address
First Line	:	1864 CONCERT DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23453-1903
Country	:	US
Telephone Number	:	757-609-4602
Fax Number	:	757-609-5721

Authorized Official
Title or Position	:	CFO
Name	:	JOHN PHILIP JONES
Credential	:
Telephone Number	:	757-609-4272

Provider Enumeration Date	:	04/07/2016
Last Update Date	:	09/07/2023

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Directions to “LIFENET HEALTH ” Practice Location

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