Healthcare Provider Details

I. General information

NPI: 1942391545
Provider Name (Legal Business Name): LIFETECH HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 06/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 N. INDIANA AVE
CROWN POINT IN
46307
US

IV. Provider business mailing address

440 W. BELL CT SUITE 400
OAK CREEK WI
53154
US

V. Phone/Fax

Practice location:
  • Phone: 888-800-9445
  • Fax: 866-469-1469
Mailing address:
  • Phone: 414-762-1300
  • Fax: 414-762-6484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number203000243
License Number StateIL

VIII. Authorized Official

Name: MS. REBECCA L TOGLIATTI
Title or Position: PRESIDENT
Credential:
Phone: 414-762-1300