Provider Demographics
NPI:1215783261
Name:MEDICAL LIFE LINE LLC
Entity type:Organization
Organization Name:MEDICAL LIFE LINE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERNELL
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-922-0184
Mailing Address - Street 1:1502 EDGE VIEW LN
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-1884
Mailing Address - Country:US
Mailing Address - Phone:832-922-0184
Mailing Address - Fax:
Practice Address - Street 1:1880 S DAIRY ASHFORD RD STE 207
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-4759
Practice Address - Country:US
Practice Address - Phone:346-229-1092
Practice Address - Fax:346-205-0327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)