Medstar Ambulance Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

4837 Issued in IL

Legal business name

MEDSTAR AMBULANCE INC

Practice address

705 Bradbury LN
Sparta, IL 62286-2102

Phone

(618) 443-5061

Fax

(618) 443-3897

NPI assigned

May 27, 2008

Last updated

May 27, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Deborah D Kelley

Title

Human Resource Manager

Phone

(618) 443-5061

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1235397282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 296",
            "city": "SPARTA",
            "state": "IL",
            "postal_code": "622860296",
            "telephone_number": "618-443-5061",
            "fax_number": "618-443-3897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 BRADBURY LN",
            "city": "SPARTA",
            "state": "IL",
            "postal_code": "622862102",
            "telephone_number": "618-443-5061",
            "fax_number": "618-443-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR AMBULANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "HUMAN RESOURCE MANAGER",
        "authorized_official_telephone_number": "618-443-5061",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "4837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Sparta, IL
• Providers in Sparta, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.