Organization
LIFECARE AMBULANCE SERVICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA ANN CARICO (ADMINISTRATIVE ASSISTANT)
(276) 679-4375
Entity
Organization
Contact information
Practice address
1728 NORTON ROAD SW, WISE, VA 24293-1069
(276) 679-4375
(276) 679-2866
Mailing address
PO BOX 1069, 1728 NORTON ROAD SW, WISE, VA 24293-1069
(276) 679-4375
(276) 679-2866
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
470
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ANTHEM
096163
VA
Enumeration date
08/19/2005
Last updated
03/11/2008
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