Provider Demographics
NPI:1326767013
Name:FIVE STAR MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:FIVE STAR MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAID
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-489-5609
Mailing Address - Street 1:1600 SHAWANO AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303-3246
Mailing Address - Country:US
Mailing Address - Phone:920-489-5609
Mailing Address - Fax:
Practice Address - Street 1:1600 SHAWANO AVE STE 108
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-3246
Practice Address - Country:US
Practice Address - Phone:920-489-5609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company