Organization
LIFESTAT OF NEO CO
Active
Other names
Lifeline EMS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENNY BROTT (CEO)
(918) 258-6579
Entity
Organization
Contact information
Practice address
102 N ELM PL, SUITE G, BROKEN ARROW, OK 74012-3883
(918) 258-6579
(918) 258-6500
Mailing address
102 N ELM PL, SUITE G, BROKEN ARROW, OK 74012-3883
(918) 258-6579
(918) 258-6500
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
387
OK
Other
Enumeration date
02/20/2007
Last updated
08/22/2020
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