Provider Demographics
NPI:1881684132
Name:LIFELINE AMBULANCE, INC.
Entity Type:Organization
Organization Name:LIFELINE AMBULANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCFARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-422-4212
Mailing Address - Street 1:P O BOX 289
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98807-0289
Mailing Address - Country:US
Mailing Address - Phone:509-663-4602
Mailing Address - Fax:509-665-4289
Practice Address - Street 1:230 GRANT RD
Practice Address - Street 2:SUITE B6
Practice Address - City:E WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-5383
Practice Address - Country:US
Practice Address - Phone:509-663-4602
Practice Address - Fax:509-665-4289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA04X05341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance