Life Line Emergency Medical Response Service Corp

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

5222 Issued in IL

Legal business name

LIFE LINE EMERGENCY MEDICAL RESPONSE SERVICE CORP

Practice address

1003 West Cherry Street
Marion, IL 62959

Phone

(618) 997-4302

Fax

(618) 997-5389

NPI assigned

May 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kevin W McConnell

Title

President Ceo

Phone

(618) 997-4302

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328140800000",
    "number": "1962459834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 WEST CHERRY STREET",
            "city": "MARION",
            "state": "IL",
            "postal_code": "62959",
            "telephone_number": "618-997-4302",
            "fax_number": "618-997-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 WEST CHERRY STREET",
            "city": "MARION",
            "state": "IL",
            "postal_code": "62959",
            "telephone_number": "618-997-4302",
            "fax_number": "618-997-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE LINE EMERGENCY MEDICAL RESPONSE SERVICE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2012-02-02",
        "status": "A",
        "authorized_official_last_name": "MCCONNELL",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "618-997-4302",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "5222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL WORKMAN COMP",
            "identifier": "610598100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "10019731",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590009057",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "080893800",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Jean Remedio Li, PAC
• Liberty Enterprises Inc.
• Christine Katherine Licina, PHARMD
• Crystal Liedtke, LCSW
• Life Home Health Care Inc. of Southern Illinois
• Joseph Lingle, RPH
• Lucille Grace Lingle, RN
• Meth Linwong, M.D.
• Jay I Lipoff, MD
• Denise Little, RN

• Land Ambulance in Marion, IL
• Providers in Marion, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.