Lifeline Pediatrics Inc

LBN: Lifeline Pediatrics Inc
Lifeline Pediatrics Inc is an health care organization with primary practice located at 100 Paducah Dr , New Martinsville WV 26155-2710. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Lifeline Pediatrics Inc can be contacted via phone (304) 455-3611, or through Ekanem, Ibanga M via phone (304) 455-3611.

Contact Information

Primary practice address
100 Paducah Dr New Martinsville WV 26155-2710
Phone: (304) 455-3611
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ekanem, Ibanga M Doctor of Medicine (MD)
Phone: (304) 455-3611

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 19922 West Virginia

Profile Details

NPI number 1598896193
LBN Legal business name Lifeline Pediatrics Inc
DBA Doing business as
Authorized official Ekanem, Ibanga M Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 8th, 2007
Last updated Aug 19th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598896193 NPPES
West Virginia MEDICAID 3810006383

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