Provider Demographics
NPI:1104371269
Name:RED STAR MEDICAL TRANSPORTATION SERVICES LLC
Entity Type:Organization
Organization Name:RED STAR MEDICAL TRANSPORTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-216-5042
Mailing Address - Street 1:881 E MAIN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-1713
Mailing Address - Country:US
Mailing Address - Phone:614-216-5042
Mailing Address - Fax:
Practice Address - Street 1:881 E MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-1713
Practice Address - Country:US
Practice Address - Phone:614-216-5042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)