Provider Demographics
NPI:1669954814
Name:LIFELINE TRANSPORT
Entity type:Organization
Organization Name:LIFELINE TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDGAR
Authorized Official - Last Name:KANE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:502-330-6263
Mailing Address - Street 1:230 NORTHLAND BLVD STE 217
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-3600
Mailing Address - Country:US
Mailing Address - Phone:502-330-6263
Mailing Address - Fax:
Practice Address - Street 1:230 NORTHLAND BLVD STE 217
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-3600
Practice Address - Country:US
Practice Address - Phone:502-330-6263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance