Provider Demographics
NPI:1376195768
Name:LIFENET, INC.
Entity Type:Organization
Organization Name:LIFENET, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:J
Authorized Official - Last Name:KECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-792-7400
Mailing Address - Street 1:PO BOX 713383
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45271-3383
Mailing Address - Country:US
Mailing Address - Phone:800-636-4438
Mailing Address - Fax:
Practice Address - Street 1:800 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:IL
Practice Address - Zip Code:62450-2553
Practice Address - Country:US
Practice Address - Phone:618-392-1890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIR METHODS CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILPENDINGMedicaid