Lifestar Ambulance Service Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

LIFESTAR AMBULANCE SERVICE INC.

Practice address

300 N Main St
Emporia, VA 23847-1608

Phone

(434) 634-1144

Fax

(434) 634-1155

NPI assigned

Jul 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Edward Franklin Bryant Jr., NREMT-P

Title

Co-Owner

Phone

(434) 634-1144

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114947322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N MAIN ST",
            "city": "EMPORIA",
            "state": "VA",
            "postal_code": "238471608",
            "telephone_number": "434-634-1144",
            "fax_number": "434-634-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N MAIN ST",
            "city": "EMPORIA",
            "state": "VA",
            "postal_code": "238471608",
            "telephone_number": "434-634-1144",
            "fax_number": "434-634-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTAR AMBULANCE SERVICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "FRANKLIN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "434-634-1144",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "NREMT-P"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "432381",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Emporia, VA
• Providers in Emporia, VA by specialty
• Land Ambulance in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.