Provider Demographics
NPI:1639410327
Name:EASTERN STAR EMS
Entity Type:Organization
Organization Name:EASTERN STAR EMS
Other - Org Name:EASTERN STAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PARAMEDIC
Authorized Official - Prefix:MR
Authorized Official - First Name:ARAKEL
Authorized Official - Middle Name:AKASHAY
Authorized Official - Last Name:MIKAELIAN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:401-323-8762
Mailing Address - Street 1:31 BLODGETT AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860
Mailing Address - Country:US
Mailing Address - Phone:401-323-8762
Mailing Address - Fax:401-723-6287
Practice Address - Street 1:31 BLODGETT AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5621
Practice Address - Country:US
Practice Address - Phone:401-323-8762
Practice Address - Fax:401-723-6287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport