LIFE LINE HOME CARE INC (NPI# 1578630190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578630190 |
| Entity Type | Organization |
| Organization Name | LIFE LINE HOME CARE INC |
| Practice Address |
3740 Saint Johns Bluff Rd S Suite 1 Jacksonville FL 32224-2651 |
| Mailing Address |
1610 Madison Ave Tifton GA 31794-3756 |
| Practice Telephone | 9047302202 |
| Practice Fax Number | 9047302212 |
| Mailing Telephone | 9047302202 |
| Mailing Fax Number | 9047302212 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2012-09-10 |
| Authorized Official Name | MR. RONNIE C DANIEL (PRESIDENT) |
| Authorized Official Telephone | 2293821334 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 1312767 | FL | Suppliers |
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
1312767 | FL | Suppliers |
| N | 333600000X | Pharmacy | PH24359 | FL | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PH24359 | FL | Suppliers |
| N | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
PH24359 | FL | Suppliers |
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
PH24359 | FL | Suppliers |
| Y | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
324181 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE | 0942290002 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902179468 | Life Line Home Care Inc | Durable Medical Equipment & Medical Supplies | 1302a Watson Blvd, Warner Robins, GA 31093-3436 | 2012-02-14 |
| 1326115130 | Life Line Home Care Inc | Durable Medical Equipment & Medical Supplies | 101 Bowens Mill Rd, Douglas, GA 31533-2254 | 2006-11-29 |
| 1891862405 | Life Line Home Care Inc | Durable Medical Equipment & Medical Supplies | 4120 Coral Park Dr, Suite E, Brunswick, GA 31520-3028 | 2006-11-29 |
| 1528026226 | Life Line Home Care Inc | Durable Medical Equipment & Medical Supplies | 1610 Madison Ave, Tifton, GA 31794-3756 | 2006-05-02 |
| 1316355076 | Life Line Home Care Inc | Durable Medical Equipment & Medical Supplies | 6409 Abercorn St, Suite F, Savannah, GA 31405-5715 | 2014-07-25 |
| 1912270471 | Life Line Home Care Inc | Durable Medical Equipment & Medical Supplies | 1350 Spring St Nw, Suite 100, Atlanta, GA 30309-2864 | 2012-02-14 |
| 1558634014 | Life Line Home Care Inc | Durable Medical Equipment & Medical Supplies | 3686 Wheeler Rd, Augusta, GA 30909-6520 | 2012-02-14 |
| 1881761492 | Life Line Home Care Inc | Durable Medical Equipment & Medical Supplies | 100 Lakeshore Dr, Suite A, Saint Marys, GA 31558-3857 | 2006-11-29 |
| 1407923022 | Life Line Home Care Inc | Durable Medical Equipment & Medical Supplies | 220 S 14th St, Fernandina Beach, FL 32034-3216 | 2006-11-29 |
| Street Address |
3740 SAINT JOHNS BLUFF RD S SUITE 1 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32224-2651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154678852 | Life Line Health Partners, LLC | Pharmacy | 3740 Saint Johns Bluff Rd S, Suite 3, Jacksonville, FL 32224-2651 | 2012-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356974372 | Noelle Parker | Specialist/Technologist | 1 Unf Drivve, Jacksonville, FL 32224 | 2020-02-18 |
| 1124685102 | Charcy Rene Stiller | Specialist/Technologist | 1 Unf Dr., Jacksonville, FL 32224 | 2019-05-24 |
| 1265097513 | Mayo Clinic Jacksonville | Ambulance | 13970 Zumbro Dr, Jacksonville, FL 32224 | 2019-05-02 |
| 1639681471 | Brigantti Anesthesia & Spine Care | Clinic/Center | 1361 13th Ave South Suite #210, Jacksonville, FL 32224 | 2017-11-02 |
| 1093240061 | Beric Emilio Berlioz | Anesthesiology | 4500 San Pablo Rd S # J, Jacksonville, FL 32224 | 2017-04-26 |
| 1609240746 | Matthew James Dailey | Nurse Anesthetist, Certified Registered | 2500 San Pablo Rd S, Jacksonville, FL 32224 | 2015-11-29 |
| 1003299603 | Upscale Personal Care Home | Assisted Living Facility | 4375 Autumn River Road, Jacksonville, FL 32224 | 2015-07-01 |
| 1629459375 | Bellanid Fonseca | Social Worker | 3694 Summerlin Ln E, Jacksonville, FL 32224 | 2015-06-17 |
| 1164840500 | Nicholas Scotto | Physical Therapist | 11555 Central Pkwy Ste 1104, Jacksonville, FL 32224 | 2014-04-02 |
| 1497093454 | Quicker Care Urgent Care | Point of Service | 13770 Beach Blvd., Unit # 4, Jacksonville, FL 32224 | 2013-01-27 |
| Find all providers in zip 32224 | ||||
| Taxonomy Code | 332BX2000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Oxygen Equipment & Supplies |
| Definition to come... |
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| 1316374366 | Matrix Medical, LLC | Durable Medical Equipment & Medical Supplies | 5121 Bowden Rd Ste 302, Jacksonville, FL 32216 | 2013-10-07 |
| 1386943785 | Realo Discount Drugs of Onslow, Inc | Durable Medical Equipment & Medical Supplies | 835 Piney Green Rd, Suite 400, Jacksonville, NC 28546-8568 | 2011-03-24 |
| 1720316011 | Braden Partners Lp | Durable Medical Equipment & Medical Supplies | 1170 Wall St, Ste 102, Jacksonville, IL 62650-4055 | 2009-11-24 |
| 1275867947 | Florida Home Medical Equipment, Inc. | Durable Medical Equipment & Medical Supplies | 5570 Florida Mining Blvd S, Suite 402, Jacksonville, FL 32257-3246 | 2009-09-28 |
| 1497902381 | Woody Weaver Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 506 E Rusk St, 101, Jacksonville, TX 75766-4992 | 2008-08-21 |
| 1689868515 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 1233 W Morton Ave, Ste A, Jacksonville, IL 62650-2774 | 2007-09-04 |
| 1295880904 | Beacon Respiratory Services, Inc. | Durable Medical Equipment & Medical Supplies | 6550 Saint Augustine Rd, Suite 101, Jacksonville, FL 32217-2835 | 2007-01-24 |
| 1487708327 | Jay Home Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 6277 Powers Ave, Jacksonville, FL 32217-2284 | 2007-01-22 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32224 |
Please comment or provide details below to improve the information on LIFE LINE HOME CARE INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.