LIFE LINE HOME CARE INC NPI 1528026226

NPI Information

NPI: 1528026226
Provider Name: LIFE LINE HOME CARE INC
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Address:
1610 MADISON AVE
TIFTON, GA
ZIP 31794
Phone: (229) 382-1334
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LIFE LINE HOME CARE INC is a durable medical equipment medical supplies in Tifton, GA. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. LIFE LINE HOME CARE INC NPI is 1528026226. The provider is registered as an organization entity type.

The provider's business location address is:

1610 MADISON AVE
TIFTON, GA
ZIP 31794-756
Phone: (229) 382-1334
Fax: (229) 382-1350

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 5/2/2006 and was last updated on 1/4/2012.

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	332BX2000X	Durable Medical Equipment & Medical Supplies	Oxygen Equipment & Supplies	PHRE007390	GEORGIA	No
2	332BP3500X	Durable Medical Equipment & Medical Supplies	Parenteral & Enteral Nutrition	PHRE007390	GEORGIA	No
3	333600000X	Pharmacy		PHRE007390	GEORGIA	No
4	3336C0004X	Pharmacy	Compounding Pharmacy	PHRE007390	GEORGIA	No
5	3336H0001X	Pharmacy	Home Infusion Therapy Pharmacy	PHRE007390	GEORGIA	No
6	3336S0011X	Pharmacy	Specialty Pharmacy	PHRE007390	GEORGIA	No
7	332B00000X	Durable Medical Equipment & Medical Supplies		1370	FLORIDA	No
8	332BX2000X	Durable Medical Equipment & Medical Supplies	Oxygen Equipment & Supplies	322562	FLORIDA	No
9	332BP3500X	Durable Medical Equipment & Medical Supplies	Parenteral & Enteral Nutrition	1370	FLORIDA	No
10	333600000X	Pharmacy		PH18569	FLORIDA	No
11	3336C0004X	Pharmacy	Compounding Pharmacy	PH18569	FLORIDA	No
12	3336H0001X	Pharmacy	Home Infusion Therapy Pharmacy	PH18569	FLORIDA	No
13	3336S0011X	Pharmacy	Specialty Pharmacy	PH18569	FLORIDA	No
14	332B00000X	Durable Medical Equipment & Medical Supplies		PHRE007390	GEORGIA	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	00494337A	MEDICAID	GEORGIA
2	1148243	OTHER	GEORGIA	NABP
3	00494337B	MEDICAID	GEORGIA
4	0942290001	MEDICARE ID-TYPE UNSPECIFIED

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

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