| Organization Name: | LIFE GUARD INC. |
| NPI Number: | 1043439276 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MATTHEW P SHIVELY (V.P.) |
| Mailing Address: | 101 S Price St Kingwood |
| State: | WV US |
| Postal Code: | 265371424 |
| Phone Number: | 3043290622 |
| Fax Number: | 3043290622 |
| NPI Enumeration Date: | 04/25/2007 |
| NPI Last Update Date: | 11/01/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |