Provider Demographics
NPI:1861965980
Name:LIFE LINES AMBULANCE SYSTEM
Entity type:Organization
Organization Name:LIFE LINES AMBULANCE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:EFREN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-242-6779
Mailing Address - Street 1:PO BOX 607071
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-7071
Mailing Address - Country:US
Mailing Address - Phone:787-242-6779
Mailing Address - Fax:
Practice Address - Street 1:Q3 -19 URB LAS LOMAS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-461-0460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-11
Last Update Date:2019-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport