MEDICARE: LIFE ALARM SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	146D00000X	Personal Emergency Response Attendant	020170	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013130335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE ALARM SERVICES, INC

Provider Business Mailing Address
First Line	:	4210 COLUMBIA RD
Second Line	:	14B
City	:	MARTINEZ
State	:	GA
Zip	:	30907-0401
Country	:	US
Telephone Number	:	180-078-0543
Fax Number	:	706-854-9787

Provider Business Practice Location Address
First Line	:	4210 COLUMBIA RD
Second Line	:	14B
City	:	MARTINEZ
State	:	GA
Zip	:	30907-0401
Country	:	US
Telephone Number	:	180-078-0543
Fax Number	:	706-854-9787

Authorized Official
Title or Position	:	PRESIDENT CEO
Name	:	MR. RONNIE L PERRY
Credential	:
Telephone Number	:	18007805433

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	05/02/2017

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