Organization
LIFE DME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERASS SAFADI (DIRECTOR)
(219) 795-1296
Entity
Organization
Contact information
Practice address
8896 LOUISIANA ST, MERRILLVILLE, IN 46410-7153
(219) 795-1296
(219) 795-1349
Mailing address
8896 LOUISIANA ST, MERRILLVILLE, IN 46410-7153
(219) 795-1296
(219) 795-1349
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
203001411
IL
332BX2000X
Oxygen Equipment & Supplies (DME)
69000307A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000536977
ANTHEM PIN
IN
05
—
200877790A
—
IN
Enumeration date
07/27/2007
Last updated
07/11/2022
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