| NPI | 1083832802 |
|---|---|
| Doing Business As | PROVIDENCE LIFELINE |
| Entity Type | Organization |
| Authorized Contact | JARED HALL Financial Manager 907-563-0130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2009-08-28 |