Healthcare Provider Details

I. General information

NPI: 1225030869
Provider Name (Legal Business Name): LIFETEAM EMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 07/05/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 WHIPPLE AVE NW STE E
NORTH CANTON OH
44720-7167
US

IV. Provider business mailing address

7100 WHIPPLE AVE NW STE E
NORTH CANTON OH
44720-7167
US

V. Phone/Fax

Practice location:
  • Phone: 330-386-5606
  • Fax: 330-232-9917
Mailing address:
  • Phone: 330-386-5606
  • Fax: 330-232-9917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number150012
License Number StateOH

VIII. Authorized Official

Name: KENNETH J JOSEPH
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 330-323-4800