LIFESTAR AMBULANCE SERVICE, INC. (NPI# 1336189653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336189653 |
| Entity Type | Organization |
| Organization Name | LIFESTAR AMBULANCE SERVICE, INC. |
| Practice Address |
4700 Broadway St Mount Vernon IL 62864-6724 |
| Mailing Address |
940 N Elm St Po Box 1838 Centralia IL 62801-2326 |
| Practice Telephone | 6182444122 |
| Practice Fax Number | 6182425152 |
| Mailing Telephone | 6185322474 |
| Mailing Fax Number | 6185327795 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROGER D. CAMPBELL (PRESIDENT) |
| Authorized Official Telephone | 6185322474 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 341600000X | Ambulance | 5225 | IL | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | APPLIED FOR | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780639823 | Lifestar Ambulance Service, Inc. | Ambulance | 528 S West St, Jacksonville, IL 62650-2873 | 2006-05-24 |
| Street Address |
4700 BROADWAY ST |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-6724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 341600000X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane). |
| Notes: Source: Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 37. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285897504 | City of Mount Vernon Fire Department | Ambulance | 1901 N Laventure Rd, Mount Vernon, WA 98273-5804 | 2008-07-07 |
| 1487707758 | Litton Ambulance Service, Inc | Ambulance | 808 S 17th St, Mount Vernon, IL 62864-4667 | 2007-01-19 |
| 1225094022 | City of Mount Vernon City Auditor | Ambulance | 200 W. Gambier Street, Mount Vernon, OH 43050-2424 | 2006-04-21 |
| 1447239322 | Lisbon - Mt Vernon Ambulance Service | Ambulance | 730 1st St E, Mount Vernon, IA 52314-1573 | 2006-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750980058 | Ivan V Knight | Ambulance | 322 Campbell Ave, Calumet City, IL 60409-2011 | 2020-10-19 |
| 1366064057 | Morris Fire & Ambulance Protection District | Ambulance | 2301 Ashton Rd, Morris, IL 60450-8615 | 2020-05-15 |
| 1821624966 | Covenant Health Ambulance Service, Inc | Ambulance | 1619b Weid Rd, Elgin, IL 60123-5825 | 2020-03-20 |
| 1053942920 | Village of Robbins | Ambulance | 3327 W 137th Street, Robbins, IL 60472-1636 | 2020-01-30 |
| 1093372187 | Vital Ambulance Services LLC | Ambulance | 18781 90th Ave., Suite A, Mokena, IL 60448 | 2019-05-23 |
| 1831668458 | Midway Ems | Ambulance | 5155 Torque Rd # B, Loves Park, IL 61111-7144 | 2018-11-14 |
| 1336637248 | Paramedic Services of Illinois, Inc. | Ambulance | 1222 W. Veterans Parkway, Yorkville, IL 60560-4728 | 2018-04-26 |
| 1255832564 | Lifeguard Ambulance Service of Illinois Inc. | Ambulance | 219 W Jackson St, Macomb, IL 61455 | 2018-02-22 |
| 1891293288 | Hamel Fire Protection District | Ambulance | 401 N Old Us Route 66, Hamel, IL 62046-1071 | 2018-01-31 |
| 1144761503 | Ah, LLC | Ambulance | 741 N Main St, Manteno, IL 60950-1254 | 2017-03-17 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
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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.