NPIMap

Organization Active NPI

Lifeguard Ambulance Service of Alabama LLC

  • Ambulance
  • Birmingham, AL
National Provider Identifier
1386947901
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
831 Issued in AL
Legal business name
LIFEGUARD AMBULANCE SERVICE OF ALABAMA LLC
Practice address
115 Walter Davis Dr
Suite C
Birmingham, AL 35209-2847
Phone
(205) 380-2065
NPI assigned
Dec 21, 2010
Last updated
Jul 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Authorized official

Name
John Roche
Title
Owner
Phone
(205) 949-1719

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 831 AL Primary
Ambulance 341600000X 971 AL

Addresses

Primary practice location

115 Walter Davis Dr
Suite C
Birmingham, AL 35209-2847

Mailing address

PO Box 190007
Birmingham, AL 35219-0007

Other identifiers 7

IdentifierTypeStateIssuer
128069MedicaidAL
1528067881OtherALTRICARE-SOUTH
51121572OtherALBCBS-AL
05373267MedicaidMS
108334MedicaidFL
136373MedicaidAL
51550455OtherALBCBS-AL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1292889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374624000000",
    "number": "1386947901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190007",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352190007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WALTER DAVIS DR",
            "address_2": "SUITE C",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352092847",
            "telephone_number": "205-380-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEGUARD AMBULANCE SERVICE OF ALABAMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-21",
        "last_updated": "2013-07-24",
        "status": "A",
        "authorized_official_last_name": "ROCHE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-949-1719"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "AL",
            "license": "831",
            "primary": true
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "AL",
            "license": "971",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128069",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE-SOUTH",
            "identifier": "1528067881",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-AL",
            "identifier": "51121572",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05373267",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108334",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136373",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-AL",
            "identifier": "51550455",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; 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.