Provider Demographics
NPI:1710451000
Name:LIFELINE EMERGENCY MEDICAL SERVICES, LLC.
Entity Type:Organization
Organization Name:LIFELINE EMERGENCY MEDICAL SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:A
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-890-1411
Mailing Address - Street 1:PO BOX 812
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30112-0015
Mailing Address - Country:US
Mailing Address - Phone:404-698-9653
Mailing Address - Fax:
Practice Address - Street 1:309 MATTHEWS AVE STE B
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-3629
Practice Address - Country:US
Practice Address - Phone:404-698-9653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-20
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance