Provider Demographics
NPI:1841284700
Name:LIFECOR, INC.
Entity type:Organization
Organization Name:LIFECOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SAPORITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-826-2108
Mailing Address - Street 1:121 FREEPORT RD
Mailing Address - Street 2:
Mailing Address - City:BLAWNOX
Mailing Address - State:PA
Mailing Address - Zip Code:15238-3411
Mailing Address - Country:US
Mailing Address - Phone:412-826-9300
Mailing Address - Fax:412-826-1024
Practice Address - Street 1:121 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:BLAWNOX
Practice Address - State:PA
Practice Address - Zip Code:15238-3411
Practice Address - Country:US
Practice Address - Phone:412-826-9300
Practice Address - Fax:412-826-1024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000002602332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA249183OtherBLUE CROSS BLUE SHIELD
1325140001Medicare ID - Type Unspecified