Provider Demographics
NPI:1942569058
Name:EMERGENCY LIFELINE WEST
Entity Type:Organization
Organization Name:EMERGENCY LIFELINE WEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-900-7543
Mailing Address - Street 1:7929 CORAL POINT AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-6756
Mailing Address - Country:US
Mailing Address - Phone:702-900-7543
Mailing Address - Fax:800-836-9968
Practice Address - Street 1:7929 CORAL POINT AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-6756
Practice Address - Country:US
Practice Address - Phone:702-900-7543
Practice Address - Fax:800-836-9968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-09
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20081041689333300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9005057086Medicaid