Healthcare Provider Details

I. General information

NPI: 1972900116
Provider Name (Legal Business Name): LIFENET, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2014
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 W LIBERTY ST
FARMINGTON MO
63640-1921
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:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number510115
License Number StateMO

VIII. Authorized Official

Name: CHRISTOPHER J BRADY
Title or Position: SECRETARY
Credential:
Phone: 800-636-4438