Provider Demographics
NPI:1598149056
Name:LIFENET, INC.
Entity Type:Organization
Organization Name:LIFENET, INC.
Other - Org Name:KIDS FLIGHT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:KEENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-915-2301
Mailing Address - Street 1:621 CARNEGIE DR
Mailing Address - Street 2:STE 210
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3536
Mailing Address - Country:US
Mailing Address - Phone:800-636-4438
Mailing Address - Fax:
Practice Address - Street 1:1 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-6722
Practice Address - Country:US
Practice Address - Phone:800-636-4438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIR METHODS CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL04 4883023416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport