Organization
LIFEGUARD INTERNATIONAL
Active
Organization
LIFEGUARD INTERNATIONAL
Active
Other names
Lifeguard Air Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN WILLIAM ROCHE EMT-P (PRESIDENT)
(850) 473-6776
Entity
Organization
Contact information
Practice address
4211 JERRY L MAYGARDEN RD, PENSACOLA, FL 32504-5029
(850) 473-6776
(850) 473-6772
Mailing address
4211 JERRY L MAYGARDEN RD, PENSACOLA, FL 32504-5029
(850) 473-6776
(850) 473-6772
Taxonomy
Speciality
Code
Description
License number
State
3416A0800X
Air Ambulance
Primary
2680
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A0586
BLUE CROSS BLUE SHIELD FL
FL
Enumeration date
07/18/2006
Last updated
08/22/2020
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