Ambu-Star, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

226 Issued in SC

Legal business name

AMBU-STAR, INC.

Practice address

154 Webber Rd
Gaffney, SC 29341-4037

Phone

(864) 488-9906

Fax

(877) 941-7812

NPI assigned

May 22, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Walter Pettiss

Title

Secretary - Treasurer

Phone

(864) 488-9906

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340236800000",
    "number": "1013127026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "COWPENS",
            "state": "SC",
            "postal_code": "293300370",
            "telephone_number": "864-488-9906",
            "fax_number": "877-941-7812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 WEBBER RD",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293414037",
            "telephone_number": "864-488-9906",
            "fax_number": "877-941-7812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBU-STAR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2012-06-21",
        "status": "A",
        "authorized_official_last_name": "PETTISS",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "SECRETARY - TREASURER",
        "authorized_official_telephone_number": "864-488-9906",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "SC",
            "license": "226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Patricia Archibald, R.N.

• All providers in Gaffney, SC
• Land Ambulance in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.