Provider Demographics
NPI:1851655898
Name:BRIGHTSTAR SERVICES LLC
Entity Type:Organization
Organization Name:BRIGHTSTAR SERVICES LLC
Other - Org Name:A1 MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TULASI
Authorized Official - Middle Name:R
Authorized Official - Last Name:POKHREL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-405-2883
Mailing Address - Street 1:7234 N 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-7931
Mailing Address - Country:US
Mailing Address - Phone:602-405-2883
Mailing Address - Fax:
Practice Address - Street 1:7234 N 19TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-7931
Practice Address - Country:US
Practice Address - Phone:602-405-2883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZCH-01405343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
706689OtherAHCCCS PROVIDER ID