Organization
LIFE GUARD INTERNATIONAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD VAN HORNE (COO)
(303) 495-1220
Entity
Organization
Contact information
Practice address
145 E RENO AVE, SUITE E7, LAS VEGAS, NV 89119-1114
(702) 740-5952
(702) 740-5951
Mailing address
FILE 56141, LOS ANGELES, CA 90074-6141
(702) 740-5952
(702) 740-5951
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
—
—
3416A0800X
Air Ambulance
Primary
—
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003202175
—
NV
Enumeration date
03/15/2007
Last updated
08/22/2019
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