Lifeline Ambulance Service, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

LIFELINE AMBULANCE SERVICE, INC.

Practice address

428 Tom Ball Road
Tazewell, TN 37879-2512

Phone

(865) 585-3952

Fax

(423) 815-1509

NPI assigned

Aug 30, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Barry G Thomas

Title

Owner

Phone

(865) 585-3952

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1154849115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 444",
            "city": "TAZEWELL",
            "state": "TN",
            "postal_code": "378790444",
            "telephone_number": "865-585-3952",
            "fax_number": "423-815-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 TOM BALL ROAD",
            "city": "TAZEWELL",
            "state": "TN",
            "postal_code": "378792512",
            "telephone_number": "865-585-3952",
            "fax_number": "423-815-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE AMBULANCE SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-30",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-585-3952",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Tazewell, TN
• Providers in Tazewell, TN by specialty
• Land Ambulance in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.