Organization
LIFEGUARD AMBULANCE SERVICE LLC
Active
Parent organization
LIFEGUARD AMBULANCE SERVICE LLC
Other names
MedStar
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFEGUARD AMBULANCE SERVICE LLC
Authorized official
TIMOTHY JOSEPH DORN (CHIEF ADMINISTRATIVE OFFICER)
(833) 703-2294
Entity
Organization
Contact information
Practice address
106 HIGHWAY 59 S, SUMMERDALE, AL 36580-3690
(417) 257-1605
(205) 380-2074
Mailing address
PO BOX 198408, ATLANTA, GA 30384-8408
(800) 913-9106
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
—
—
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000930029
—
MS
05
—
020743700
—
FL
05
—
197945
—
AL
05
—
7100572180
—
KY
05
—
Q030101
—
TN
Enumeration date
08/19/2016
Last updated
09/15/2025
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