Provider Demographics
NPI:1962450429
Name:LIFEHME, INC.
Entity type:Organization
Organization Name:LIFEHME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DEWEY
Authorized Official - Last Name:ROOF
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:803-254-8775
Mailing Address - Street 1:312 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:THOMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30824-2121
Mailing Address - Country:US
Mailing Address - Phone:706-597-8747
Mailing Address - Fax:706-597-8742
Practice Address - Street 1:312 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-2121
Practice Address - Country:US
Practice Address - Phone:706-597-8747
Practice Address - Fax:706-597-8742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA301380159332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00933149AMedicaid
GA00733149AMedicaid
GA00733149BMedicaid
GA0754830002Medicare ID - Type Unspecified