Life Line Home Care Inc

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

55-8013641105-5 Issued in FL

Legal business name

LIFE LINE HOME CARE INC

Practice address

220 S 14TH St
Fernandina Beach, FL 32034-3216

Phone

(904) 321-0242

Fax

(904) 321-0930

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Ronnie C Daniel, PHARMD

Title

President

Phone

(229) 382-1334

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1407923022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 MADISON AVE",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943756",
            "telephone_number": "904-321-0242",
            "fax_number": "904-321-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S 14TH ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343216",
            "telephone_number": "904-321-0242",
            "fax_number": "904-321-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE LINE HOME CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "DANIEL",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-382-1334",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "FL",
            "license": "55-8013641105-5",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0942290004",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriella Leon, ISW
• Vanessa Lewallen, LAC
• Warren Zachary Lewis, LMT
• Jeffrey Mark Lezynski, AUD
• Jo Lichten, PHD, RDN
• Chel Ho Lim
• Kevin Lin, D.C.
• Sherry Sue Linback, ARNP
• Jennifer C Little
• Alex Llarena, MD

• Oxygen Equipment & Supplies (DME) in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Oxygen Equipment & Supplies (DME) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; 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.