Healthcare Provider Details

I. General information

NPI: 1770251142
Provider Name (Legal Business Name): LIFENET, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2021
Last Update Date: 09/01/2021
Certification Date: 09/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 S HWY 59
PARSONS KS
67357-4948
US

IV. Provider business mailing address

PO BOX 713383
CINCINNATI OH
45271-3383
US

V. Phone/Fax

Practice location:
  • Phone: 800-636-4438
  • Fax:
Mailing address:
  • Phone: 800-636-4438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier100411320E
Identifier TypeMEDICAID
Identifier StateKS
Identifier Issuer

VIII. Authorized Official

Name: SHARON J KECK
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 303-792-7400