LIFE LINE HOME CARE INC NPI 1578630190

NPI Information

NPI: 1578630190
Provider Name: LIFE LINE HOME CARE INC
Classification: Durable Medical Equipment & Medical Supplies - 332BX2000X
Entity Type: Organization

Specialization: Oxygen Equipment & Supplies

Address:
3740 SAINT JOHNS BLUFF RD S
SUITE 1
JACKSONVILLE, FL
ZIP 32224
Phone: (904) 730-2202
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LIFE LINE HOME CARE INC is an oxygen equipment and supplies durable medical equipment medical supplies in Jacksonville, FL. LIFE LINE HOME CARE INC NPI is 1578630190. The provider is registered as an organization entity type.

The provider's business location address is:

3740 SAINT JOHNS BLUFF RD S
SUITE 1
JACKSONVILLE, FL
ZIP 32224-651
Phone: (904) 730-2202
Fax: (904) 730-2212

The provider's authorized official is Ronnie C Daniel .
The authorized official title is President and has the following contact phone number (229) 382-1334.

The enumeration date for this NPI number is 11/29/2006 and was last updated on 9/10/2012.

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	332B00000X	Durable Medical Equipment & Medical Supplies		1312767	FLORIDA	No
2	332BP3500X	Durable Medical Equipment & Medical Supplies	Parenteral & Enteral Nutrition	1312767	FLORIDA	No
3	333600000X	Pharmacy		PH24359	FLORIDA	No
4	3336C0004X	Pharmacy	Compounding Pharmacy	PH24359	FLORIDA	No
5	3336H0001X	Pharmacy	Home Infusion Therapy Pharmacy	PH24359	FLORIDA	No
6	3336S0011X	Pharmacy	Specialty Pharmacy	PH24359	FLORIDA	No
7	332BX2000X	Durable Medical Equipment & Medical Supplies	Oxygen Equipment & Supplies	324181	FLORIDA	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	Other Provider Identifier Issuer
1	0942290002	OTHER	FLORIDA	MEDICARE

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: 11/14/2023

NPI Synchronization or Removal

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