Provider Demographics
NPI:1477715688
Name:LIFE STAR EMS INC
Entity Type:Organization
Organization Name:LIFE STAR EMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAED
Authorized Official - Middle Name:SALEEM
Authorized Official - Last Name:ABU ALREESH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-321-1999
Mailing Address - Street 1:4047 HOLCOMB BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-1879
Mailing Address - Country:US
Mailing Address - Phone:404-321-1999
Mailing Address - Fax:
Practice Address - Street 1:4047 HOLCOMB BRIDGE RD
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-1879
Practice Address - Country:US
Practice Address - Phone:404-321-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-29
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044-273416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport