Organization
LIFE LINE HOME CARE INC
Active
Organization
LIFE LINE HOME CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY J DANIEL (COO)
(229) 382-1334
Entity
Organization
Contact information
Practice address
403 EH CT, BRUNSWICK, GA 31520-2192
(912) 554-0088
(912) 554-0087
Mailing address
1610 MADISON AVE, TIFTON, GA 31794-3756
(912) 554-0088
(912) 554-0087
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
303718769
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0942290003
MEDICARE
GA
Enumeration date
11/29/2006
Last updated
08/30/2022
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