Provider Demographics
NPI:1952673121
Name:LIFETRANS, INC.
Entity Type:Organization
Organization Name:LIFETRANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AVO
Authorized Official - Middle Name:
Authorized Official - Last Name:AVETISYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-888-7750
Mailing Address - Street 1:3280 COLEMAN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-7704
Mailing Address - Country:US
Mailing Address - Phone:702-982-1000
Mailing Address - Fax:702-629-2852
Practice Address - Street 1:3280 COLEMAN ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-7704
Practice Address - Country:US
Practice Address - Phone:702-982-1000
Practice Address - Fax:702-629-2852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVM27-000076154567343900000X
NV2000108-831343900000X
NV87248343900000X
NV3-4-09-1223-7343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)