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General NPI Number Information
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NPI Number | 1265258941
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Entity Type | Organization
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Legal Business Name | LIFEBRIDGE DME LLC
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Dates
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Enumeration Date | 11/27/2024
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Last Update Date | 12/25/2024
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Provider Practice Location Address
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Address Line | 1 HIGHHAVEN PL APT TB
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City | NOTTINGHAM
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State | MD
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Zip | 21236-3266
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Country | US
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Telephone | 516-225-3473
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Fax |
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Provider Business Mailing Address
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Address Line | 44 LEATHERWOOD PL APT F
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City | ROSEDALE
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State | MD
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Zip | 21237-3512
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Country | US
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Telephone | 516-225-3473
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MADIHA REHMAN
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Credential |
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Telephone | 516-225-3473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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