MEDICARE: STARS TRANSPORTATION SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1013725431
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STARS TRANSPORTATION SERVICES LLC

Provider Business Mailing Address
First Line	:	3160 CHERRY LAKE LN STE B
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46235-8613
Country	:	US
Telephone Number	:	317-622-2095
Fax Number	:	317-622-2095

Provider Business Practice Location Address
First Line	:	3160 CHERRY LAKE LN STE B
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46235-8613
Country	:	US
Telephone Number	:	317-622-2095
Fax Number	:	317-622-2095

Authorized Official
Title or Position	:	RN
Name	:	SANDRA L IVY
Credential	:
Telephone Number	:	317-622-2095

Provider Enumeration Date	:	12/19/2024
Last Update Date	:	12/19/2024

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