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General NPI Number Information
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NPI Number | 1518058197
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Entity Type | Organization
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Legal Business Name | SIERRA LIFESTAR INC.,
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 234 N M ST
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City | TULARE
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State | CA
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Zip | 93274-4139
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Country | US
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Telephone | 559-688-2550
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Fax | 559-688-2714
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Provider Business Mailing Address
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Address Line | PO BOX 1101
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City | TULARE
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State | CA
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Zip | 93275-1101
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Country | US
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Telephone | 559-688-2550
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Fax | 559-688-2714
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | MS. JACKIE K BERST
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Credential |
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Telephone | 559-688-2550
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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 | AMB06/005
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License Number State | CA
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