Provider Demographics
NPI:1295199156
Name:LIFENET HEALTH
Entity Type:Organization
Organization Name:LIFENET HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-609-4272
Mailing Address - Street 1:1864 CONCERT DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-1903
Mailing Address - Country:US
Mailing Address - Phone:757-609-4602
Mailing Address - Fax:757-609-5721
Practice Address - Street 1:1864 CONCERT DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-1903
Practice Address - Country:US
Practice Address - Phone:757-609-4602
Practice Address - Fax:757-609-5721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA332B00000X, 335U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335U00000XSuppliersOrgan Procurement Organization