Provider Demographics
NPI:1982362620
Name:LIFELINE MEDICAL GROUP
Entity Type:Organization
Organization Name:LIFELINE MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-761-1277
Mailing Address - Street 1:1415 W HIGH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-6848
Mailing Address - Country:US
Mailing Address - Phone:610-871-1547
Mailing Address - Fax:610-871-1548
Practice Address - Street 1:1415 W HIGH ST STE 100
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-6848
Practice Address - Country:US
Practice Address - Phone:610-871-1547
Practice Address - Fax:610-871-1548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care