Provider Demographics
NPI:1881422830
Name:NORTHSTAR LIFE SAFETY SERVICES
Entity type:Organization
Organization Name:NORTHSTAR LIFE SAFETY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:FETTIG
Authorized Official - Suffix:
Authorized Official - Credentials:NRP
Authorized Official - Phone:320-309-0654
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MN
Mailing Address - Zip Code:56374-0100
Mailing Address - Country:US
Mailing Address - Phone:320-309-0654
Mailing Address - Fax:
Practice Address - Street 1:32472 91ST AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MN
Practice Address - Zip Code:56374-8651
Practice Address - Country:US
Practice Address - Phone:320-309-0654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No344600000XTransportation ServicesTaxi