Healthcare Provider Details

I. General information

NPI: 1699575993
Provider Name (Legal Business Name): LIFE TEAM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 CHURCH ST # A
LILLY PA
15938-1166
US

IV. Provider business mailing address

PO BOX 18533
PITTSBURGH PA
15236-0533
US

V. Phone/Fax

Practice location:
  • Phone: 814-201-1968
  • Fax:
Mailing address:
  • Phone: 814-201-1968
  • Fax: 724-615-1448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MRS. ASHLEY R ECKENRODE
Title or Position: PRESIDENT
Credential:
Phone: 814-201-1968