Lifeline Concord LLC

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

LIFELINE CONCORD LLC

Practice address

1340 John a Papalas Dr
Lincoln Park, MI 48146-1356

Phone

(313) 386-9400

NPI assigned

Oct 3, 2017

Organization subpart

No

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

Authorized official

Name

John J Herlihy

Title

Ceo

Phone

(847) 933-9348

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Locations

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642032000000",
    "number": "1205346319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 CHASE AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600764008",
            "telephone_number": "847-933-9348",
            "fax_number": "847-933-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 JOHN A PAPALAS DR",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481461356",
            "telephone_number": "313-386-9400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1409 Allen Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480834003",
            "country_code": "US",
            "telephone_number": "847-933-9348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFELINE CONCORD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A",
        "authorized_official_last_name": "HERLIHY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-933-9348"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKayla Leigh-Clark
• Andrew Lewandoski
• Angelika Lewis, LSW
• James P. Lewis, LMSW
• John Lewis, L.M.S.W.
• Lifesmart Medical Center PLLC
• Lifesmart Pharmacy LLC
• Lincoln DME Care Supply LLC
• Lincoln Park Dental Associates
• Lincoln Park Family Dentistry DDS PC

• Ambulance in Lincoln Park, MI
• Providers in Lincoln Park, MI by specialty
• Ambulance in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.