# LIFELINE EMS LLC

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

## Provider details

- **NPI number:** 1114091147
- **Authorized official:** MR. DAVID DONOVAN (CEO)
- **Authorized official phone:** (870) 462-8003

## Contact information

- **Practice address:** 146 DR. HERD E. STONE, HOLLY GROVE, AR 72069
- **Practice address phone:** (870) 462-8003
- **Mailing address:** PO BOX 592, HOLLY GROVE, AR 72069-0592
- **Mailing address phone:** (870) 462-8003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 319 | AR | Yes |

## Other

- **Enumeration date:** 11/20/2006
- **Last updated:** 08/22/2020