Provider Demographics
NPI:1225481617
Name:LIFELINE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:LIFELINE TRANSPORTATION LLC
Other - Org Name:LIFELINE TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DHAHA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-552-5552
Mailing Address - Street 1:6877 1/2 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-3074
Mailing Address - Country:US
Mailing Address - Phone:619-552-5552
Mailing Address - Fax:
Practice Address - Street 1:6877 1/2 AMHERST ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-3074
Practice Address - Country:US
Practice Address - Phone:619-552-5552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker