Provider Demographics
NPI:1770585812
Name:LIFENET, INC.
Entity type:Organization
Organization Name:LIFENET, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:SNAVELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-832-8531
Mailing Address - Street 1:6300 HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-0007
Mailing Address - Country:US
Mailing Address - Phone:903-832-8531
Mailing Address - Fax:903-832-0215
Practice Address - Street 1:6300 HAMPTON RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-0007
Practice Address - Country:US
Practice Address - Phone:903-832-8531
Practice Address - Fax:903-832-0215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX019005341600000X, 3416A0800X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered341600000XTransportation ServicesAmbulance
Not Answered3416A0800XTransportation ServicesAmbulanceAir Transport
Not Answered3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX517405Medicare ID - Type Unspecified