Provider Demographics
NPI:1467073338
Name:LIFECARE AMBULANCE LLC
Entity Type:Organization
Organization Name:LIFECARE AMBULANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HERLIHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-933-9348
Mailing Address - Street 1:6423 SHELBY VIEW DR STE 112
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-7614
Mailing Address - Country:US
Mailing Address - Phone:901-372-0190
Mailing Address - Fax:901-372-0160
Practice Address - Street 1:6423 SHELBY VIEW DR STE 112
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-7614
Practice Address - Country:US
Practice Address - Phone:901-372-0190
Practice Address - Fax:901-372-0160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-02
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance