Provider Demographics
NPI:1083823561
Name:FIVESTAR TRANSPORTATION INC
Entity Type:Organization
Organization Name:FIVESTAR TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:K
Authorized Official - Last Name:CUTTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-673-0266
Mailing Address - Street 1:2548 GALLINI DRIVE
Mailing Address - Street 2:49 SOUTH DAY STREET ORANGE, NEW JERSEY 07050
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083
Mailing Address - Country:US
Mailing Address - Phone:973-673-0266
Mailing Address - Fax:
Practice Address - Street 1:49 S DAY ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07050-3503
Practice Address - Country:US
Practice Address - Phone:973-673-0266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5020506343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)