Provider Demographics
NPI:1891260691
Name:1 LIFELINE MEDICAL TRANSPORT
Entity Type:Organization
Organization Name:1 LIFELINE MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:
Authorized Official - Last Name:ALRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-448-7169
Mailing Address - Street 1:281 CUMBERLAND BND APT 434
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1825
Mailing Address - Country:US
Mailing Address - Phone:615-448-7169
Mailing Address - Fax:
Practice Address - Street 1:281 CUMBERLAND BND APT 434
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1825
Practice Address - Country:US
Practice Address - Phone:615-448-7169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)