| Organization Name: | LIFE LINE MEDICAL EQUIPMENT, INC |
| NPI Number: | 1205999356 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SYLVIA DIANNE BASTOW (PRESIDENT) |
| Mailing Address: | 110 E Lula St Suite B Leesville |
| State: | LA US |
| Postal Code: | 714464363 |
| Phone Number: | 3372399100 |
| Fax Number: | 3372399222 |
| NPI Enumeration Date: | 12/19/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BP3500X |
| License Number: | 9086059-001 0 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Parenteral & Enteral Nutrition |
| Taxonomy Definition: | |