Provider Demographics
NPI:1427017532
Name:NORTHSTAR EMS INC.
Entity Type:Organization
Organization Name:NORTHSTAR EMS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:SHULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-268-2353
Mailing Address - Street 1:1701 E BEEBE CAPPS EXPY
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-6897
Mailing Address - Country:US
Mailing Address - Phone:501-268-2327
Mailing Address - Fax:501-268-7026
Practice Address - Street 1:1701 E BEEBE CAPPS EXPY
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-6897
Practice Address - Country:US
Practice Address - Phone:501-268-2327
Practice Address - Fax:501-268-7026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR274341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR141323715Medicaid
AR141323715Medicaid