Organization
LORAIN LIFECARE AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER C. ANDRE DE LA PORTE (PRESIDENT)
(440) 323-6111
Entity
Organization
Contact information
Practice address
109 W. 23RD STREET, LORAIN, OH 44052-4801
(440) 244-2336
(440) 244-1012
Mailing address
640 CLEVELAND STREET, ELYRIA, OH 44035-4104
(440) 323-6111
(440) 365-2266
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
470092
OH
341600000X
Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0689401
—
OH
Enumeration date
04/13/2006
Last updated
08/10/2012
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