Provider Demographics
NPI:1407186232
Name:NORTHSTAR EMS INC
Entity Type:Organization
Organization Name:NORTHSTAR EMS INC
Other - Org Name:MARION COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-247-4748
Mailing Address - Street 1:PO BOX 2788
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35403-2788
Mailing Address - Country:US
Mailing Address - Phone:205-752-5866
Mailing Address - Fax:205-345-7911
Practice Address - Street 1:201 BANKHEAD HWY
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594-5309
Practice Address - Country:US
Practice Address - Phone:205-487-7911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-29
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9983416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51103865OtherBLUE CROSS BLUE SHIELD
AL10116502Medicaid
AL10116502Medicaid