Provider Demographics
NPI:1225433147
Name:STAR CARE AMBULANCE LLC
Entity Type:Organization
Organization Name:STAR CARE AMBULANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:M
Authorized Official - Last Name:YAMBAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-881-0481
Mailing Address - Street 1:393 WILLIAMS AVE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-6517
Mailing Address - Country:US
Mailing Address - Phone:201-881-0481
Mailing Address - Fax:732-283-4020
Practice Address - Street 1:393 WILLIAMS AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-6517
Practice Address - Country:US
Practice Address - Phone:201-881-0481
Practice Address - Fax:732-283-4020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1007043416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport