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LIFE LINE CORPORATION -4 LLC
NPI 1639821648
Internal Medicine in Westminster, MD

Active since January 20, 2022CLIA Certified · 2 labs
349 MALCOLM DR, WESTMINSTER, MD 21157(410) 848-2566 Get Directions Write a Review

NPPES record last updated: September 10, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 10, 2025, Jan 20, 2022 (2 updates tracked since 2022).

About Life Line Corporation -4 Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFE LINE CORPORATION -4 LLC (NPI 1639821648) is a healthcare organization registered as an internal medicine in Westminster, Maryland and active in the NPI registry since January 2022. The organization holds 2 active CLIA laboratory certificates, maintains 2 additional practice locations, and lists Kamal G. Bangoria, President, as its authorized official.

NPPES Registry Identity

NPI1639821648
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameLIFE LINE CORPORATION -4 LLC
Location Address349 MALCOLM DRWestminster, MD 21157-6106
Mailing Address1798 Oden WayEldersburg, MD 21784-7095 · (443) 255-3951
Phone(410) 848-2566
Organization SubpartNo
Authorized OfficialKamal G. BangoriaPresident · (443) 255-3951
Enumeration DateJanuary 20, 2022
Last NPPES UpdateSeptember 10, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 10, 2025
✔ NPI 1639821648 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedHospitalistTaxonomy 208M00000X
349 MALCOLM DR, Westminster, MD 21157
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Secondary Practice Locations 2

Location 12111 Hanover PikeHampstead, MD 21074-1319 · Phone (410) 239-7073
Location 2295 Stoner Ave Ste 106Westminster, MD 21157-5663 · Phone (443) 255-3951

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2273596

Life Line Corporation -4 LLC · Hampstead, MD
Active · expires Dec 14, 2026
CLIA Number21D2273596
Laboratory TypePhysician Office
Certificate Effective DateDecember 15, 2024
Certificate Expiration DateDecember 14, 2026
Laboratory DirectorKamal G. Bangoria
Laboratory Phone(443) 255-3951
Laboratory LocationLife Line Corporation -4 LLC2111 Hanover Pike, Hampstead, MD 21074
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 21D2270714

Life Line Corporation -4 LLC · Westminster, MD
Active · expires Oct 19, 2026
CLIA Number21D2270714
Laboratory TypePhysician Office
Certificate Effective DateOctober 20, 2024
Certificate Expiration DateOctober 19, 2026
Laboratory DirectorKamal G. Bangoria
Laboratory Phone(410) 848-2566
Laboratory LocationLife Line Corporation -4 LLC295 Stoner Ave Suite 106, Westminster, MD 21157
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAMAN KANERIA MD
Internal Medicine
349 MALCOLM DR
WESTMINSTER, MD 21157
Carroll County (410) 848-2566
KAMAL GORDHANBHAI BANGORIA M.D.
Internal Medicine
349 MALCOLM DR
WESTMINSTER, MD 21157
Carroll County (410) 848-2566

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Life Line Corporation -4 LLC's NPI number?

The NPI number for Life Line Corporation -4 LLC is 1639821648. It was assigned to this organization in the NPPES registry on January 20, 2022.

Where is Life Line Corporation -4 LLC located?

Life Line Corporation -4 LLC is located at 349 Malcolm Dr, Westminster, MD 21157. The listed phone number is (410) 848-2566.

What is Life Line Corporation -4 LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Life Line Corporation -4 LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Life Line Corporation -4 LLC was last updated on September 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.