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Organization
LIFE GUARD INC.
Active
Organization
LIFE GUARD INC.
Active
Other names
Preston Home Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONLUC TYRONE HARRIS (VICE PRESIDENT)
(304) 834-5370
Entity
Organization
Contact information
Practice address
204 W MAIN ST, KINGWOOD, WV 26537-1419
(304) 329-0622
(304) 329-0522
Mailing address
204 W MAIN ST, KINGWOOD, WV 26537-1419
(304) 329-0622
(304) 329-0622
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810009478
—
WV
Enumeration date
04/25/2007
Last updated
05/12/2025
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