Organization
LIFE SHIELD EMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVE THACH (CEO)
(678) 814-4550
Entity
Organization
Contact information
Practice address
1158 FOREST PKWY, SUITE A, LAKE CITY, GA 30260-3464
(678) 814-4550
(770) 783-6622
Mailing address
1158 FOREST PKWY, SUITE A, LAKE CITY, GA 30260-3464
(678) 814-4550
(770) 783-6622
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
031-25
GA
341600000X
Ambulance
031-26
GA
Other
Enumeration date
12/17/2010
Last updated
02/18/2014
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