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General NPI Number Information
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NPI Number | 1053977744
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Entity Type | Organization
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Legal Business Name | LIFE LINE EMS, LLC
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Dates
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Enumeration Date | 05/17/2019
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 4143 BLUEBONNET DR
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City | STAFFORD
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State | TX
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Zip | 77477-3909
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Country | US
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Telephone | 832-203-8778
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Fax | 832-532-3697
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Provider Business Mailing Address
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Address Line | 4143 BLUEBONNET DR
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City | STAFFORD
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State | TX
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Zip | 77477-3909
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Country | US
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Telephone | 832-203-8778
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Fax | 832-532-3697
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Authorized Official
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Title or Position | MANAGER
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Name | NONYE OZONOH
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Credential |
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Telephone | 832-203-8778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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