# LIFELINE REGIONAL AMBULANCE, INC.

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

## Provider details

- **NPI number:** 1164539284
- **Authorized official:** MR. JOSEPH LANCE LANE EMT (PRESIDENT)
- **Authorized official phone:** (843) 374-3911

## Contact information

- **Practice address:** 239 N ACLINE ST, LAKE CITY, SC 29560-2159
- **Practice address phone:** (843) 374-3911
- **Practice address fax:** (843) 394-9111
- **Mailing address:** 239 N ACLINE ST, LAKE CITY, SC 29560-2159
- **Mailing address phone:** (843) 374-3911
- **Mailing address fax:** (843) 394-9111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 077 | SC | Yes |

## Other

- **Enumeration date:** 08/24/2006
- **Last updated:** 06/24/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | AB0243 | — | SC |