Lifeguard International

Primary specialty

Air AmbulanceTaxonomy code 3416A0800X

License

2680 Issued in FL

Legal business name

LIFEGUARD INTERNATIONAL

Practice address

4211 Jerry L Maygarden Rd
Pensacola, FL 32504-5029

Phone

(850) 473-6776

Fax

(850) 473-6772

NPI assigned

Jul 18, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John William Roche, EMT-P

Title

President

Phone

(850) 473-6776

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lifeguard Air Ambulance Former legal business name

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174541098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 JERRY L MAYGARDEN RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045029",
            "telephone_number": "850-473-6776",
            "fax_number": "850-473-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 JERRY L MAYGARDEN RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045029",
            "telephone_number": "850-473-6776",
            "fax_number": "850-473-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEGUARD INTERNATIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROCHE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-473-6776",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "EMT-P"
    },
    "taxonomies": [
        {
            "code": "3416A0800X",
            "taxonomy_group": "",
            "desc": "Ambulance, Air Transport",
            "state": "FL",
            "license": "2680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FL",
            "identifier": "A0586",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifeguard Air Ambulance",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Air Ambulance in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Air Ambulance in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.