LIFETIME HEALTH CLINIC NPI 1639275712

NPI Information

NPI: 1639275712
Provider Name: LIFETIME HEALTH CLINIC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
868 NORTHWEST GARDEN VALLEY BOULEVARD
ROSEBURG, OR
ZIP 97470
Phone: (541) 673-4513
Get Directions

LIFETIME HEALTH CLINIC is a cardiovascular disease internal medicine in Roseburg, OR. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. LIFETIME HEALTH CLINIC NPI is 1639275712. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

868 NORTHWEST GARDEN VALLEY BOULEVARD
ROSEBURG, OR
ZIP 97470-959
Phone: (541) 673-4513
Fax: (541) 672-6384

The provider's authorized official is John D Sproed .
The authorized official title is Physician Owner and has the following contact phone number (541) 673-4513.

The enumeration date for this NPI number is 9/15/2006 and was last updated on 7/3/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	115984	MEDICARE ID-TYPE UNSPECIFIED	OREGON	MEDICARE GROUP ID NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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