JOHNSON LIFE CARE, INC; NPI #1619933470

Contact Information

JOHNSON LIFE CARE, INC

310 WEST MAIN STREET
LYNCH, KY 40855

Phone: 606-848-2861
Fax: 606-848-2409
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Land Transport	3416L0300X	59	Ambulance Service Provider

Indicates primary specialty

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NPI Profile & details for JOHNSON LIFE CARE, INC

NPI # 1619933470

LBN Legal business name JOHNSON LIFE CARE, INC

Authorized official DARREL VANOVER - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 04/21/2006

Last updated 11/04/2011 - About 15 years ago

Identifiers

KY	License #	1609
KY	Medicaid	55048078
KY	Medicaid	56004179
TN	Medicaid	4582350
VA	Medicaid	010121078
KY	Other	089589600	BLACK LUNG
KY	Other	000000070292	BLUE CROSS BLUE SHIELD
KY	Other	50011660	PASSPORT HEALTH
KY	Other	590011400	RAILROAD MEDICARE
KY	Other	1416591	UNITED MINE WORKERS

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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