Lifeline Ambulance
Organization Active NPI Ambulance · Lugoff, SC
NPI 1235434853 · NPPES record last updated Jan 12, 2011
Key facts
- NPI
- 1235434853
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- Legal business name
- LIFELINE AMBULANCE
- Practice address
- 106 Caledonia CT
Lugoff, SC 29078-9707 - Phone
- (803) 243-4444
- NPI assigned
- Jan 12, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- LIFELINE AMBULANCE, LLC
Authorized official
- Name
- Mrs. Katie G Cobb
- Title
- Owner
- Phone
- (803) 243-4444
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110411000088 | SC | Part B Supplier - Ambulance Service Supplier | 4587848916 | Practice locations: Lugoff, SC |
National Provider Directory
- Part of
- Lifeline Ambulance
Locations
16 Dooley Dr
Lugoff, SC 29078
Phone (803) 432-8325
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Yes |
Addresses
Primary practice location
106 Caledonia CT
Lugoff, SC 29078-9707
Mailing address
PO Box 206
Lugoff, SC 29078-0206
Phone (803) 243-4444
Other providers in Lugoff, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.