MEDICARE: ECLIPSE STAR 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	:	1598480709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ECLIPSE STAR LLC

Provider Business Mailing Address
First Line	:	215 S WADSWORTH BLVD STE 520
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-1566
Country	:	US
Telephone Number	:	720-965-5557
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 S WADSWORTH BLVD STE 520
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-1566
Country	:	US
Telephone Number	:	720-965-5557
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NATHAN ADMASSU
Credential	:
Telephone Number	:	720-965-5557

Provider Enumeration Date	:	10/10/2022
Last Update Date	:	04/16/2025

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