Life Ambulance Service Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

License

730012 Issued in OH

Legal business name

LIFE AMBULANCE SERVICE INC

Practice address

1641 Offnere St
Portsmouth, OH 45662-3537

Phone

(740) 353-7725

Fax

(740) 354-1859

NPI assigned

May 18, 2006

Organization subpart

No

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

Authorized official

Name

Carol Deaterla

Title

Billing Department Manager

Phone

(740) 353-7725

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1487607727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 OFFNERE ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623537",
            "telephone_number": "740-353-7725",
            "fax_number": "740-354-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 OFFNERE ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623537",
            "telephone_number": "740-353-7725",
            "fax_number": "740-354-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE AMBULANCE SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "DEATERLA",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "BILLING DEPARTMENT MANAGER",
        "authorized_official_telephone_number": "740-353-7725"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "OH",
            "license": "730012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55000160",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000043000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0595771",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Orlando Lee Lewis
• Rodrick Lewis
• Vickie H Lewis, CRNA
• Liberty Nursing Center of Portsmouth Inc
• Life Air Inc
• Life Care Diagnostic, LLC
• Life Care Home Health II
• Life Care Home Medical Equipment, LLC
• Life Emergency Medical Services
• Life Medical Response, Inc.

• Ambulance in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Ambulance in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.