Provider Demographics
NPI:1700800331
Name:LIFELINE CENTERS PC
Entity Type:Organization
Organization Name:LIFELINE CENTERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-351-6545
Mailing Address - Street 1:1525 PARK MANOR BLVD STE 308
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-4805
Mailing Address - Country:US
Mailing Address - Phone:412-351-6545
Mailing Address - Fax:412-351-6547
Practice Address - Street 1:2030 ARDMORE BLVD
Practice Address - Street 2:251
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-4652
Practice Address - Country:US
Practice Address - Phone:412-351-6545
Practice Address - Fax:412-273-1958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA117507OtherMEDICARE PTAN