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General NPI Number Information
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NPI Number | 1558430330
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Entity Type | Organization
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Legal Business Name | NORTHSTAR EMS, LLC
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 2022 HUMBLE PLACE DR
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City | HUMBLE
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State | TX
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Zip | 77338-5281
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Country | US
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Telephone | 281-548-7772
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Fax | 281-540-6669
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Provider Business Mailing Address
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Address Line | PO BOX 2526
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City | HUMBLE
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State | TX
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Zip | 77347-2526
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Country | US
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Telephone | 281-548-7772
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Fax | 281-540-6669
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Authorized Official
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Title or Position | CEO
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Name | MRS. DONNA P RUSSELL
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Credential |
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Telephone | 281-548-7772
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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 | 300217
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License Number State | TX
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