Provider Demographics
NPI:1013783653
Name:LIFE LINE TRANSPORT LLC
Entity type:Organization
Organization Name:LIFE LINE TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-999-9988
Mailing Address - Street 1:440 BENMAR DR STE 1085
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-3252
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:440 BENMAR DR STE 1085
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3252
Practice Address - Country:US
Practice Address - Phone:281-999-9988
Practice Address - Fax:281-999-9982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)