Provider Demographics
NPI:1013130335
Name:LIFE ALARM SERVICES, INC
Entity Type:Organization
Organization Name:LIFE ALARM SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1800-780-5433
Mailing Address - Street 1:4210 COLUMBIA RD
Mailing Address - Street 2:14B
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-0401
Mailing Address - Country:US
Mailing Address - Phone:180-078-0543
Mailing Address - Fax:706-854-9787
Practice Address - Street 1:4210 COLUMBIA RD
Practice Address - Street 2:14B
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-0401
Practice Address - Country:US
Practice Address - Phone:180-078-0543
Practice Address - Fax:706-854-9787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA020170146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000635896DMedicaid
GA000635896CMedicaid
SC=========Medicaid