Provider Demographics
NPI:1376609230
Name:LIFESAFE SECURITY CORPORATION
Entity Type:Organization
Organization Name:LIFESAFE SECURITY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:FINLEY
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-286-1083
Mailing Address - Street 1:PO BOX 645
Mailing Address - Street 2:
Mailing Address - City:FINLEY
Mailing Address - State:TN
Mailing Address - Zip Code:38030-0645
Mailing Address - Country:US
Mailing Address - Phone:731-286-1083
Mailing Address - Fax:731-287-1352
Practice Address - Street 1:5324 HIGHWAY 104 WEST
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024
Practice Address - Country:US
Practice Address - Phone:731-286-1083
Practice Address - Fax:731-287-1352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0803974Medicaid