LIFELINE EMS LLC NPI 1174705859

NPI Information

  • NPI: 1174705859
  • Provider Name: LIFELINE EMS LLC
  • Classification: Ambulance - 3416L0300X
  • Specialization: Land Transport
  • Entity Type: Organization
  • Address: 510 E JACKSON AVE
    WEST MEMPHIS, AR
    ZIP 72301
  • Phone: (870) 735-9718

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NPI Details

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
13416L0300XAmbulanceLand Transport0000010018TENNESSEEYes

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
1186922715MEDICAIDARKANSAS
23574503MEDICARE PINTENNESSEE
347420MEDICARE PINARKANSAS
4T000212MEDICAIDTENNESSEE

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: 11/21/2025

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