Organization
LIFELINE PENSACOLA, LLC
Active
Other names
Coastal Vascular & Interventional Center
Organization subpart
No
Provider details
NPI number
Authorized official
JASON LOHMEYER (CFO)
(847) 949-3855
Entity
Organization
Contact information
Practice address
1851 N 9TH AVE STE B, PENSACOLA, FL 32503-5201
(850) 912-8843
(850) 432-0802
Mailing address
PO BOX 782412, PHILADELPHIA, PA 19178-2412
(847) 388-2001
(847) 388-2020
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Enumeration date
12/14/2012
Last updated
06/30/2021
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