LIFESTAR AMBULANCE SERVICE INC. (NPI# 1114947322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114947322 |
| Entity Type | Organization |
| Organization Name | LIFESTAR AMBULANCE SERVICE INC. |
| Practice Address |
300 N Main St Emporia VA 23847-1608 |
| Practice Telephone | 4346341144 |
| Practice Fax Number | 4346341155 |
| Mailing Telephone | 4346341144 |
| Mailing Fax Number | 4346341155 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. EDWARD FRANKLIN BRYANT JR. (CO-OWNER) |
| Authorized Official Telephone | 4346341144 |
| Authorized Official Credential | NREMT-P |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ANTHEM BLUE CROSS | 432381 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Lifestar Ambulance Service Inc. | 300 North Main St, Emporia, Virginia 23847 |
| Street Address |
300 N MAIN ST |
| City | EMPORIA |
| State | VA |
| Zip Code | 23847-1608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831689454 | Laniesha Stephens Dunn | Social Worker | 407 Halifax St Ste 3, Emporia, VA 23847 | 2018-05-18 |
| 1073016382 | Audrey O Brown | Private Vehicle | 2926 Slagles Road, Emporia, VA 23847 | 2018-03-13 |
| 1598280844 | Daisy's Transportation LLC | Driver | 710 N. Main Street, Emporia, VA 23847 | 2017-08-08 |
| 1336486836 | From Start 2 Finish Counseling Services, Inc | Community/Behavioral Health | 425d South Main Street, Emporia, VA 23847 | 2013-01-03 |
| 1316245681 | William Robert Shannonhouse Jr. | Pharmacist | 220 Market Drive, Emporia, VA 23847 | 2011-03-10 |
| 1669791984 | District 19 Community Services Board | Nursing Care | 502 Sadler Dr, Emporia, VA 23847 | 2010-05-26 |
| 1740310143 | Harold J Neal, Jr. Dds, PC | Dentist | 508 Belfield Dr., Emporia, VA 23847 | 2007-03-06 |
| 1376637504 | Charles V Omick | Nurse Anesthetist, Certified Registered | 727 North Main Street, Emporia, VA 23847 | 2006-10-03 |
| 1669496030 | Prince Squire Medical Center PC | Family Medicine | 219 Weaver Avenue, Emporia, VA 23847 | 2006-07-27 |
| 1003838442 | Marcelin Medical Center | Clinic/Center | 137 Baker Sreet, Emporia, VA 23847 | 2006-07-24 |
| Find all providers in zip 23847 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
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|---|---|---|---|---|
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.