Healthcare Provider Details

I. General information

NPI: 1265406854
Provider Name (Legal Business Name): NORTHSTAR EMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6285 PARK SOUTH DR STE 200
BESSEMER AL
35022-5670
US

IV. Provider business mailing address

PO BOX 2788
TUSCALOOSA AL
35403-2788
US

V. Phone/Fax

Practice location:
  • Phone: 205-424-1909
  • Fax:
Mailing address:
  • Phone: 205-752-5866
  • Fax: 205-345-7911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number545
License Number StateAL

VIII. Authorized Official

Name: MR. JON ANTHONY SMELLEY
Title or Position: CEO
Credential:
Phone: 205-247-4748