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General NPI Number Information
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NPI Number | 1558518969
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Entity Type | Organization
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Legal Business Name | LIFESTAR EMERGENCY MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 08/27/2008
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Last Update Date | 10/16/2018
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Provider Practice Location Address
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Address Line | 29 RT 113 SUITE B
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City | ALBANY
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State | NH
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Zip | 03818
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Country | US
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Telephone | 603-447-1210
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Fax | 603-447-1214
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Provider Business Mailing Address
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Address Line | PO BOX 788
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City | WEST OSSIPEE
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State | NH
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Zip | 03890-0788
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Country | US
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Telephone | 603-447-1210
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Fax | 603-447-1214
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | BRIAN EDWARD JOHNS
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Credential | PARAMEDIC
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Telephone | 603-733-8559
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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 |
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License Number State |
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