Provider Demographics
NPI:1700034899
Name:5 STAR MEDICAL TRANSPORT, LLC
Entity Type:Organization
Organization Name:5 STAR MEDICAL TRANSPORT, LLC
Other - Org Name:5 STAR MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:REDMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-558-4050
Mailing Address - Street 1:420 PLUMMER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-3116
Mailing Address - Country:US
Mailing Address - Phone:757-558-4050
Mailing Address - Fax:757-487-9633
Practice Address - Street 1:801 BUTLER ST
Practice Address - Street 2:SUITE 5
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-3404
Practice Address - Country:US
Practice Address - Phone:757-558-4050
Practice Address - Fax:757-487-9633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA94343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)