MEDSTAR AMBULANCE INC NPI 1013900364

NPI Information

NPI: 1013900364
Provider Name: MEDSTAR AMBULANCE INC
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
705 BRADBURY LN
SPARTA, IL
ZIP 62286
Phone: (618) 443-5061
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MEDSTAR AMBULANCE INC is a land transport ambulance in Sparta, IL. MEDSTAR AMBULANCE INC NPI is 1013900364. The provider is registered as an organization entity type.

The provider's business location address is:

705 BRADBURY LN
SPARTA, IL
ZIP 62286-102
Phone: (618) 443-5061
Fax: (618) 443-3897

The provider's authorized official is Deborah D Kelley .
The authorized official title is Humanresources Manager and has the following contact phone number (618) 443-5061.

The enumeration date for this NPI number is 8/23/2005 and was last updated on 5/27/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416L0300X	Ambulance	Land Transport	44837	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	133392100	OTHER		AWCE/DEPT OF LABOR
2	0007915009	OTHER		BCBS
3	133392100	OTHER		HEALTHCARE USA
4	=========MED	OTHER		MERCY HEALTHPLAN
5	088141300	OTHER		FEDERAL BLACK LUNG
6	154099XX	OTHER		PREFERRED CARE
7	590007217	MEDICARE PIN	ILLINOIS
8	=========002	OTHER	ILLINOIS	MEDICAID
9	676300	MEDICARE PIN	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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