Provider Demographics
NPI:1801562863
Name:BLUE STAR MEDICAL TRANSPORT INC
Entity type:Organization
Organization Name:BLUE STAR MEDICAL TRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERICH
Authorized Official - Middle Name:
Authorized Official - Last Name:ALFONSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-632-7985
Mailing Address - Street 1:2355 SALZEDO ST STE 209
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5035
Mailing Address - Country:US
Mailing Address - Phone:305-632-7985
Mailing Address - Fax:
Practice Address - Street 1:2355 SALZEDO ST STE 209
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5035
Practice Address - Country:US
Practice Address - Phone:305-632-7985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-19
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance