Healthcare Provider Details

I. General information

NPI: 1821089202
Provider Name (Legal Business Name): MEDSTAR AMBULANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 BATTLES ST
LEOMINSTER MA
01453-1502
US

IV. Provider business mailing address

PO BOX 5
LEOMINSTER MA
01453-0005
US

V. Phone/Fax

Practice location:
  • Phone: 978-466-8883
  • Fax: 978-534-9650
Mailing address:
  • Phone: 978-466-8883
  • Fax: 978-534-9650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number3038
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number3038
License Number StateMA

VIII. Authorized Official

Name: MR. NICHOLAS MELEHOV
Title or Position: DIRECTOR
Credential:
Phone: 978-466-8883