Healthcare Provider Details

I. General information

NPI: 1295199156
Provider Name (Legal Business Name): LIFENET HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 09/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1864 CONCERT DR
VIRGINIA BEACH VA
23453-1903
US

IV. Provider business mailing address

1864 CONCERT DR
VIRGINIA BEACH VA
23453-1903
US

V. Phone/Fax

Practice location:
  • Phone: 757-609-4602
  • Fax: 757-609-5721
Mailing address:
  • Phone: 757-609-4602
  • Fax: 757-609-5721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code335U00000X
TaxonomyOrgan Procurement Organization
License Number
License Number StateVA

VIII. Authorized Official

Name: JOHN PHILIP JONES
Title or Position: CFO
Credential:
Phone: 757-609-4272