| Organization Name: | LIFECARE AMBULANCE SERVICE, INC. |
| NPI Number: | 1205828779 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PATRICIA ANN CARICO (ADMINISTRATIVE ASSISTANT) |
| Mailing Address: | 1728 Norton Road Sw Wise |
| State: | VA US |
| Postal Code: | 242931069 |
| Phone Number: | 2766794375 |
| Fax Number: | 2766792866 |
| NPI Enumeration Date: | 08/19/2005 |
| NPI Last Update Date: | 03/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 470 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |