MEDICARE: LIFELINE TRANSPORT 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	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1578426359
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFELINE TRANSPORT INC

Provider Business Mailing Address
First Line	:	64 BUTTONWORTH DR
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32137-9403
Country	:	US
Telephone Number	:	561-322-8414
Fax Number	:

Provider Business Practice Location Address
First Line	:	64 BUTTONWORTH DR
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32137-9403
Country	:	US
Telephone Number	:	561-322-8414
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ASCANIA ALFRED
Credential	:
Telephone Number	:	561-322-8414

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “LIFELINE TRANSPORT INC ” Practice Location

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