LIFELINE EMS LLC NPI 1174705859

NPI Information

NPI: 1174705859
Provider Name: LIFELINE EMS LLC
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
510 E JACKSON AVE
WEST MEMPHIS, AR
ZIP 72301
Phone: (870) 735-9718
Get Directions

LIFELINE EMS LLC is a land transport ambulance in West Memphis, AR. LIFELINE EMS LLC NPI is 1174705859. The provider is registered as an organization entity type.

The provider's business location address is:

510 E JACKSON AVE
WEST MEMPHIS, AR
ZIP 72301-336
Phone: (870) 735-9718
Fax: (870) 735-9718

The provider's authorized official is Charlie Andrew Tacito .
The authorized official title is Owner and has the following contact phone number (901) 619-3127.

The enumeration date for this NPI number is 12/4/2007 and was last updated on 6/22/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416L0300X	Ambulance	Land Transport	0000010018	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	186922715	MEDICAID	ARKANSAS
2	3574503	MEDICARE PIN	TENNESSEE
3	47420	MEDICARE PIN	ARKANSAS
4	T000212	MEDICAID	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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