Organization
JOHNSON LIFE CARE, INC
Active
Organization
JOHNSON LIFE CARE, INC
Active
Other names
Johnson Life Care Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARREL VANOVER EMT (OWNER)
(606) 848-2861
Entity
Organization
Contact information
Practice address
310 WEST MAIN STREET, LYNCH, KY 40855
(606) 848-2861
(606) 848-2409
Mailing address
PO BOX 728, LYNCH, KY 40855-0728
(606) 848-2861
(606) 848-2409
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1609
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000070292
BLUE CROSS BLUE SHIELD
KY
05
—
010121078
—
VA
01
—
089589600
BLACK LUNG
KY
01
—
1416591
UNITED MINE WORKERS
KY
05
—
4582350
—
TN
01
—
50011660
PASSPORT HEALTH
KY
05
—
55048078
—
KY
05
—
56004179
—
KY
01
—
590011400
RAILROAD MEDICARE
KY
Enumeration date
04/21/2006
Last updated
11/04/2011
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