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Contact Information

LIFE LINE EMERGENCY MEDICAL RESPONSE SERVICE CORP
1003 WEST CHERRY STREET
MARION, IL62959
 Phone: 618-997-4302
 Fax: 618-997-5389
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Land Transport

3416L0300X 59 Ambulance Service Provider
Indicates primary specialty

NPI Profile & details for LIFE LINE EMERGENCY MEDICAL RESPONSE SERVICE CORP

NPI Number 1962459834
LBN Legal business name LIFE LINE EMERGENCY MEDICAL RESPONSE SERVICE CORP
Authorized official KEVIN MCCONNELL - (PRESIDENT CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 05/27/2006
Last updated 02/02/2012 - About 14 years ago
Identifiers
IL License # 5222
Other 080893800 FEDERAL BLACK LUNG
Other 610598100 FEDERAL WORKMAN COMP
Other 590009057 RAILROAD MEDICARE
IL Other 10019731 BLUE CROSS BLUE SHIELD
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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