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General NPI Number Information
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NPI Number | 1124154133
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Entity Type | Organization
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Legal Business Name | LIFE CARE MEDICAL, INC.
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 104 PARK ST
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City | STERLING
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State | CO
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Zip | 80751-4135
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Country | US
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Telephone | 970-522-6802
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Fax | 970-251-9960
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Provider Business Mailing Address
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Address Line | 104 PARK ST
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City | STERLING
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State | CO
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Zip | 80751-4135
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Country | US
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Telephone | 970-522-6802
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Fax | 970-251-9960
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Authorized Official
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Title or Position | CEO
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Name | MR. DOUGLAS DEAN SMITH
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Credential | MSM, EMT-P
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Telephone | 97052268022
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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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