# LIFE-FORCE AMBULANCE, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LIFE-FORCE AMBULANCE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558674895
- **Authorized official:** MR. ROGER CARROLL BURGESS (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (770) 853-6453

## Contact information

- **Practice address:** 301 W I PKWY, SUITE D, DALLAS, GA 30132-5066
- **Practice address phone:** (678) 363-3622
- **Practice address fax:** (678) 363-5929
- **Mailing address:** 301 W I PKWY, SUITE D, DALLAS, GA 30132-5066
- **Mailing address phone:** (678) 363-3622
- **Mailing address fax:** (678) 363-5929

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | GA | Yes |

## Other

- **Enumeration date:** 07/15/2010
- **Last updated:** 04/21/2011