Provider Demographics
NPI:1558518969
Name:LIFESTAR EMERGENCY MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:LIFESTAR EMERGENCY MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:JOHNS
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:603-733-8559
Mailing Address - Street 1:PO BOX 788
Mailing Address - Street 2:
Mailing Address - City:WEST OSSIPEE
Mailing Address - State:NH
Mailing Address - Zip Code:03890-0788
Mailing Address - Country:US
Mailing Address - Phone:603-447-1210
Mailing Address - Fax:603-447-1214
Practice Address - Street 1:29 RT 113 SUITE B
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NH
Practice Address - Zip Code:03818
Practice Address - Country:US
Practice Address - Phone:603-447-1210
Practice Address - Fax:603-447-1214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-27
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport