MEDICARE: LIFENET, 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	3416A0800X	Air Ambulance	510115	MO

General Provider Information

NPI Number	:	1407399280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFENET, INC.

Provider Business Mailing Address
First Line	:	PO BOX 713383
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45271-3383
Country	:	US
Telephone Number	:	888-636-4438
Fax Number	:

Provider Business Practice Location Address
First Line	:	2207 SCOTT AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63103-3031
Country	:	US
Telephone Number	:	888-636-4438
Fax Number	:

Authorized Official
Title or Position	:	SENIOR DIRECTOR
Name	:	MATTHEW D SMITH
Credential	:
Telephone Number	:	888-636-4438

Provider Enumeration Date	:	11/28/2016
Last Update Date	:	11/28/2016

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