Life Guard Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LIFE GUARD INC

Practice address

1736 S Pleasants Hwy
Saint Marys, WV 26170-4981

Phone

(304) 299-5063

Fax

(304) 299-5060

NPI assigned

Jul 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. Jonluc Tyrone Harris

Title

Vice President

Phone

(304) 834-5370

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Life Guard Medical Supply Doing business as

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Life Guard Inc.

  • Oxygen Equipment & Supplies (DME)
  • Kingwood, WV
  • NPI 1043439276

  3375660541

  Same PAC ID
• Life Guard Inc.

  • Oxygen Equipment & Supplies (DME)
  • Spencer, WV
  • NPI 1912068180

  3375660541

  Same PAC ID

Tax ID family

Life Guard Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Life Guard Inc

  • Oxygen Equipment & Supplies (DME)
  • MC Connelsville, OH
  • NPI 1518027150
  NPD tax ID

Locations

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747008000000",
    "number": "1992728208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 S PLEASANTS HWY",
            "city": "SAINT MARYS",
            "state": "WV",
            "postal_code": "261704981",
            "telephone_number": "304-299-5063",
            "fax_number": "304-299-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1736 S PLEASANTS HWY",
            "city": "SAINT MARYS",
            "state": "WV",
            "postal_code": "261704981",
            "telephone_number": "304-299-5063",
            "fax_number": "304-299-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE GUARD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "JONLUC",
        "authorized_official_middle_name": "TYRONE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "304-834-5370",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0147202000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0232573",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Guard Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Connie A Lamp
• Jody Lamp
• Larry Lamp
• Nicole Lancaster
• Alicia Nicole Lester
• Nicole Longwell, BCBA
• Osric Armand Malone-Prioleau, APRN, CRC
• Marietta Memorial Hospital of Tyler County Inc
• Michael Mauzy, DO
• Crystal McKinney

• Durable Medical Equipment & Medical Supplies in Saint Marys, WV
• Providers in Saint Marys, WV by specialty
• Durable Medical Equipment & Medical Supplies in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; 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.