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General NPI Number Information
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NPI Number | 1942631320
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Entity Type | Organization
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Legal Business Name | LIFELINE MEDICAL SERVICES INC
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Dates
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Enumeration Date | 12/10/2013
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Last Update Date | 11/16/2015
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Provider Practice Location Address
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Address Line | 15-19 HEDDEN PL
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City | NEWARK
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State | NJ
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Zip | 07107-1614
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Country | US
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Telephone | 866-874-7774
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Fax | 215-674-1907
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Provider Business Mailing Address
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Address Line | 15-19 HEDDEN PL
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City | NEWARK
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State | NJ
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Zip | 07107-1614
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Country | US
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Telephone | 866-841-7774
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Fax | 215-674-1907
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | BARBARA RUSSO
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Credential |
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Telephone | 866-841-7774
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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 | LIFL04008
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License Number State | NJ
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