Provider Demographics
NPI:1285033100
Name:MEDSTAR TRANS, LLC
Entity Type:Organization
Organization Name:MEDSTAR TRANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:BARSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-807-2224
Mailing Address - Street 1:1149 S NORTHLAKE DR
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-1316
Mailing Address - Country:US
Mailing Address - Phone:917-807-2224
Mailing Address - Fax:
Practice Address - Street 1:1149 S NORTHLAKE DR
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33019-1316
Practice Address - Country:US
Practice Address - Phone:917-807-2224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL343900000XOtherNON-EMERGENCY MEDICAL TRANSPORT (VAN)