Provider Demographics
NPI:1619927811
Name:ST LUKES EMERGENCY & TRANSPORT SERVICES, INC
Entity Type:Organization
Organization Name:ST LUKES EMERGENCY & TRANSPORT SERVICES, INC
Other - Org Name:LIFESTAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VP OF FINANCE/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:R
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-538-4546
Mailing Address - Street 1:PO BOX 780533
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0533
Mailing Address - Country:US
Mailing Address - Phone:215-538-4546
Mailing Address - Fax:215-529-5287
Practice Address - Street 1:124 S 10TH ST
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1504
Practice Address - Country:US
Practice Address - Phone:215-538-4543
Practice Address - Fax:215-529-5287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA090403416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA590004866OtherPALMETTO GBA MEDICARE
PA0010915920004Medicaid
PA0010915920004Medicaid