Provider Demographics
NPI:1629288519
Name:STARLITE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:STARLITE TRANSPORTATION LLC
Other - Org Name:TRI STATE AMBULANCE & AMBULETTE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NARKETTA
Authorized Official - Middle Name:NICHELLE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-531-1548
Mailing Address - Street 1:601 MILL ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-5440
Mailing Address - Country:US
Mailing Address - Phone:513-531-1548
Mailing Address - Fax:
Practice Address - Street 1:601 MILL ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-5440
Practice Address - Country:US
Practice Address - Phone:513-531-1548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2500896Medicaid