Provider Demographics
NPI:1629033865
Name:LIFE-LINE PARAMEDICS LLC
Entity Type:Organization
Organization Name:LIFE-LINE PARAMEDICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JONAH
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-636-1043
Mailing Address - Street 1:PO BOX 426
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36784-0426
Mailing Address - Country:US
Mailing Address - Phone:334-636-1043
Mailing Address - Fax:
Practice Address - Street 1:1526 MOSLEY DR
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:AL
Practice Address - Zip Code:36784-3321
Practice Address - Country:US
Practice Address - Phone:334-636-1043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL8983416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00217892OtherUNITED HEALTH CARE/RRR
P00217892OtherUNITED HEALTH CARE/RRR
=========OtherTRICARE