Organization
LIFE LINE AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN SCOTT TIERNEY (EVP, CHIEF FINANCIAL OFFICER)
(833) 703-2294
Entity
Organization
Contact information
Practice address
915 HINMAN ST, PRESCOTT, AZ 86305-1619
(928) 445-3814
Mailing address
PO BOX 847102, DALLAS, TX 75284-7102
(800) 913-9106
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
EMS2878
AZ
341600000X
Ambulance
—
—
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070136
—
AZ
Enumeration date
06/01/2005
Last updated
02/19/2026
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