Provider Demographics
NPI:1912972928
Name:LIFEFLEET LLC
Entity Type:Organization
Organization Name:LIFEFLEET LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-518-5253
Mailing Address - Street 1:PO BOX 390
Mailing Address - Street 2:
Mailing Address - City:NORTH LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:44452-0390
Mailing Address - Country:US
Mailing Address - Phone:330-549-9739
Mailing Address - Fax:330-549-9741
Practice Address - Street 1:11000 MARKET ST
Practice Address - Street 2:
Practice Address - City:NORTH LIMA
Practice Address - State:OH
Practice Address - Zip Code:44452-9775
Practice Address - Country:US
Practice Address - Phone:330-549-9739
Practice Address - Fax:330-549-9741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5002423416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000339587OtherANTHEM
OHP00202203OtherRAILROAD MEDICARE
OH1492265OtherAETNA
OH2493234Medicaid
OH800601OtherBLACK LUNG
OH800601OtherBLACK LUNG
OH=========00OtherOH WORKERS COMP
OHP00202203OtherRAILROAD MEDICARE
OH1492265OtherAETNA