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General NPI Number Information
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NPI Number | 1942259817
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Entity Type | Organization
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Legal Business Name | LIFELINE TRANSPORT INC.
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 05/29/2008
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Provider Practice Location Address
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Address Line | 492 29TH ST
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City | OAKLAND
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State | CA
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Zip | 94609-3500
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Country | US
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Telephone | 510-663-3333
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Fax | 510-663-2433
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Provider Business Mailing Address
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Address Line | 492 29TH ST
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City | OAKLAND
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State | CA
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Zip | 94609-3500
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Country | US
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Telephone | 510-663-3333
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Fax | 510-663-2433
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Authorized Official
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Title or Position | CEO
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Name | MR. DANIEL NELSON GRIFFITH
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Credential |
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Telephone | 510-760-3904
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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 | 1891
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License Number State | CA
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