Lifecare Ambulance, Inc.

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

LIFECARE AMBULANCE, INC.

Practice address

205 West Avenue
Elyria, OH 44035-5309

Phone

(440) 323-6111

Fax

(440) 365-2266

NPI assigned

Apr 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Peter C. Andre de la Porte

Title

President

Phone

(440) 323-6111

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1790742781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 CLEVELAND STREET",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440354104",
            "telephone_number": "440-323-6111",
            "fax_number": "440-365-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 WEST AVENUE",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355309",
            "telephone_number": "440-323-6111",
            "fax_number": "440-365-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECARE AMBULANCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "ANDRE DE LA PORTE",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-323-6111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0634648",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth John Lewis
• Tracey A Lewis
• Diandra Liccardo
• Liengkong Siew MD Inc
• Brenda J Life, CNP
• Lifecare Wheelchair Transportation, Inc.
• Katherine A Lightner
• Theresa Linden
• Lindsey Knoepp LLC
• Bretzyl M Liscoe

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.