NPIMap

Organization Active NPI

Lifeline Med Supplies LLC

  • Durable Medical Equipment & Medical Supplies
  • Baltimore, MD
National Provider Identifier
1205557840
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
LIFELINE MED SUPPLIES LLC
Practice address
529 Old Town Mall
Baltimore, MD 21202-4191
Phone
(410) 963-2602
NPI assigned
Sep 12, 2022
Last updated
Sep 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Authorized official

Name
Mr. Michael WestbrookNPI 1033794763
Title
C.E.O.
Phone
(410) 963-2602

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

529 Old Town Mall
Baltimore, MD 21202-4191

Mailing address

529 Old Town Mall
Baltimore, MD 21202-4191
Phone (410) 963-2602

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michael@impactliveshealthservices.com Direct Impact Lives Health Services, LLC

National Provider Directory

National Provider Directory

Locations

529 Old Town Mall
Baltimore, MD 21202
Phone (410) 963-2602

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1205557840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 OLD TOWN MALL",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212024191",
            "telephone_number": "410-963-2602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 OLD TOWN MALL",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212024191",
            "telephone_number": "410-963-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE MED SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-10",
        "status": "A",
        "authorized_official_last_name": "WESTBROOK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "410-963-2602",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael@impactliveshealthservices.com",
            "affiliation": "Y",
            "endpointDescription": "e-mail",
            "affiliationName": "Impact Lives Health Services, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "529 Old Town Mall",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212024191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.