# LIFE SHIELD EMS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063715738
- **Authorized official:** MR. STEVE THACH (CEO)
- **Authorized official phone:** (678) 814-4550

## Contact information

- **Practice address:** 1158 FOREST PKWY, SUITE A, LAKE CITY, GA 30260-3464
- **Practice address phone:** (678) 814-4550
- **Practice address fax:** (770) 783-6622
- **Mailing address:** 1158 FOREST PKWY, SUITE A, LAKE CITY, GA 30260-3464
- **Mailing address phone:** (678) 814-4550
- **Mailing address fax:** (770) 783-6622

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 031-25 | GA | Yes |
| 341600000X | Ambulance | 031-26 | GA | — |

## Other

- **Enumeration date:** 12/17/2010
- **Last updated:** 02/18/2014