Provider Demographics
NPI:1457003873
Name:BLUESTAR PERSONAL AND TRANSPORTATION SERVICES LLC
Entity Type:Organization
Organization Name:BLUESTAR PERSONAL AND TRANSPORTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAVA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-461-0911
Mailing Address - Street 1:2554 BRIAR LN
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-4615
Mailing Address - Country:US
Mailing Address - Phone:419-461-0911
Mailing Address - Fax:
Practice Address - Street 1:2554 BRIAR LN
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-4615
Practice Address - Country:US
Practice Address - Phone:419-461-0911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-26
Last Update Date:2023-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)