Life Ambulance Service Inc.

Primary specialty

AmbulanceTaxonomy code 341600000X

License

071015 Issued in TX

Legal business name

LIFE AMBULANCE SERVICE INC.

Practice address

5720 Trowbridge Dr
Suite B
El Paso, TX 79925-3341

Phone

(915) 772-1642

Fax

(915) 877-2234

NPI assigned

Dec 13, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rachel B. Harracksingh, MBA

Title

Evp

Phone

(915) 772-1642

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861477762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26486",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799266486",
            "telephone_number": "915-772-1642",
            "fax_number": "915-877-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5720 TROWBRIDGE DR",
            "address_2": "SUITE B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799253341",
            "telephone_number": "915-772-1642",
            "fax_number": "915-877-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE AMBULANCE SERVICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARRACKSINGH",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "915-772-1642",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "TX",
            "license": "071015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R0746",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marco Antonio Licon, MS,CCC-SLP
• Octavio Licon, MD
• Oscar Licon, LMT
• Lidia Estefany Licona
• Joel Kenneth Lien, RD,LD
• Life Ambulance Service Inc.
• Life Care Chiropractic & Rehabilitation Centers
• Life Journey Counseling LLC
• Lifeworks Services, LLC
• Evan Andrew Liggett, MD

• Ambulance in El Paso, TX
• Providers in El Paso, TX by specialty
• Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.