Healthcare Provider Details

I. General information

NPI: 1912972928
Provider Name (Legal Business Name): LIFEFLEET LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 12/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11000 MARKET ST
NORTH LIMA OH
44452-9775
US

IV. Provider business mailing address

PO BOX 390
NORTH LIMA OH
44452-0390
US

V. Phone/Fax

Practice location:
  • Phone: 330-549-9739
  • Fax: 330-549-9741
Mailing address:
  • Phone: 330-549-9739
  • Fax: 330-549-9741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number500242
License Number StateOH

VIII. Authorized Official

Name: JEFF LOWERY
Title or Position: PRESIDENT
Credential:
Phone: 330-518-5253