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NPI Code Detail

MEDICARE: LIFE MEDICAL RESPONSE, INC.

MEDICARE: LIFE MEDICAL RESPONSE, 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
13416L0300XLand Ambulance730522OH

General Provider Information

NPI Number : 1871803593
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFE MEDICAL RESPONSE, INC.
Provider Business Mailing Address
First Line : 729 6TH ST
Second Line :
City : PORTSMOUTH
State : OH
Zip : 45662-4030
Country : US
Telephone Number : 740-354-6169
Fax Number : 740-351-1421
Provider Business Practice Location Address
First Line : 729 6TH ST
Second Line :
City : PORTSMOUTH
State : OH
Zip : 45662-4030
Country : US
Telephone Number : 740-354-6169
Fax Number : 740-355-9109
Authorized Official
Title or Position : CEO/OWNER
Name : MR. MICHAEL C PISTOLE
Credential :
Telephone Number : 740-354-6169
Provider Enumeration Date : 10/15/2010
Last Update Date : 10/15/2010

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Directions to “LIFE MEDICAL RESPONSE, INC. ” Practice Location

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