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General NPI Number Information
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NPI Number | 1386837557
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Entity Type | Organization
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Legal Business Name | LIFELINE MED. INC
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 912 S VICTORY BLVD
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City | BURBANK
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State | CA
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Zip | 91502-2429
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Country | US
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Telephone | 818-588-3281
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Fax | 818-230-2252
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Provider Business Mailing Address
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Address Line | 912 S VICTORY BLVD
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City | BURBANK
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State | CA
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Zip | 91502-2429
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Country | US
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Telephone | 818-588-3281
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Fax | 818-230-2252
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Authorized Official
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Title or Position | PRESDENT
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Name | RUBEN SHAHINIAN
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Credential |
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Telephone | 818-588-3281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 000225251200019
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License Number State | CA
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