International Life Support Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

INTERNATIONAL LIFE SUPPORT INC

Practice address

99-1379 Koaha PL
Aiea, HI 96701-3269

Phone

(808) 487-4900

Fax

(808) 486-1765

NPI assigned

May 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Timothy Joseph Dorn

Title

Chief Administrative Officer

Phone

(833) 703-2294

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• American Medical Response (AMR) Doing business as

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• American Medical Response of Colorado Inc

  • Land Ambulance
  • Rocky Ford, CO
  • NPI 1740956614

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1013967769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749667",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900749667",
            "telephone_number": "800-913-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99-1379 KOAHA PL",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967013269",
            "telephone_number": "808-487-4900",
            "fax_number": "808-486-1765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL LIFE SUPPORT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A",
        "authorized_official_last_name": "DORN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "833-703-2294"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008337",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Medical Response (AMR)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "American Medical Response (AMR)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Aiea, HI
• Ambulance in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.