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General NPI Number Information
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NPI Number | 1407018823
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Entity Type | Organization
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Legal Business Name | EMSSTAR LLC
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 620 N GRAHAM ST
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City | ALLENTOWN
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State | PA
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Zip | 18109-2049
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Country | US
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Telephone | 215-764-8803
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Fax | 215-827-5608
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Provider Business Mailing Address
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Address Line | 300 DOMINO LN
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City | PHILADELPHIA
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State | PA
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Zip | 19128-4352
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Country | US
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Telephone | 215-764-8803
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Fax | 215-827-5608
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DEAN A BOLLENDORF
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Credential |
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Telephone | 215-764-8803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | EMST22015
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | EMST22015
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 04228
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License Number State | PA
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