NPIMap

Organization Active NPI

Emsstar, LLC

  • Land Ambulance
  • Philadelphia, PA
National Provider Identifier
1316920630
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
04228 Issued in PA
Legal business name
EMSSTAR, LLC
Practice address
300 Domino LN
Philadelphia, PA 19128-4352
Phone
(215) 764-8803
NPI assigned
Nov 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Authorized official

Name
Mr. Dean A Bollendorf
Title
Marketing
Phone
(215) 764-8803

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X EMST22015 NJ
Ambulance 341600000X 04228 PA
Land Ambulance 3416L0300X 04228 PA Primary
Land Ambulance 3416L0300X EMST22015 NJ
Non-emergency Medical Transport (VAN) 343900000X EMST22015 NJ

Addresses

Primary practice location

300 Domino LN
Philadelphia, PA 19128-4352

Mailing address

300 Domino LN
Philadelphia, PA 19128-4352
Phone (215) 764-8803

Other identifiers 2

IdentifierTypeStateIssuer
0077488MedicaidNJ
1011955800001MedicaidPA

Other names 1

  • EM-STAR AMBULANCE SERVICE Doing business as

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328054400000",
    "number": "1316920630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 DOMINO LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191284352",
            "telephone_number": "215-764-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 DOMINO LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191284352",
            "telephone_number": "215-764-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMSSTAR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2012-02-01",
        "status": "A",
        "authorized_official_last_name": "BOLLENDORF",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MARKETING",
        "authorized_official_telephone_number": "215-764-8803",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NJ",
            "license": "EMST22015",
            "primary": false
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "PA",
            "license": "04228",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "04228",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NJ",
            "license": "EMST22015",
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NJ",
            "license": "EMST22015",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0077488",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011955800001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EM-STAR AMBULANCE SERVICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; 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.