OSF LIFELINE AMBULANCE LLC NPI 1619036829

NPI Information

NPI: 1619036829
Provider Name: OSF LIFELINE AMBULANCE, LLC
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
318 ROXBURY RD
ROCKFORD, IL
ZIP 61107
Phone: (815) 395-4695
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OSF LIFELINE AMBULANCE, LLC is a land transport ambulance in Rockford, IL. OSF LIFELINE AMBULANCE, LLC NPI is 1619036829. The provider is registered as an organization entity type.

The provider's business location address is:

318 ROXBURY RD
ROCKFORD, IL
ZIP 61107-090
Phone: (815) 395-4695
Fax: (805) 395-4643

The provider's authorized official is James M Moore .
The authorized official title is Ceo and has the following contact phone number (309) 655-2850.

The enumeration date for this NPI number is 12/6/2006 and was last updated on 4/9/2014.

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			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	471203	OTHER	ILLINOIS	BLUE CROSS
2	=========001	MEDICAID	ILLINOIS
3	207199	MEDICARE PIN	ILLINOIS
4	P00073030	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS	RAILROAD 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: 4/28/2024

NPI Synchronization or Removal

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