NPIMap

Organization Active NPI

Killen Ctr Star Rescue

  • Land Ambulance
  • Killen, AL
National Provider Identifier
1477634459
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
777 Issued in AL
Legal business name
KILLEN CTR STAR RESCUE
Practice address
207 J C Mauldin Hwy
Killen, AL 35645-9146
Phone
(256) 757-5012
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Authorized official

Name
Jay Golliver
Title
Director
Phone
(256) 757-5012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 777 AL Primary

Addresses

Primary practice location

207 J C Mauldin Hwy
Killen, AL 35645-9146

Mailing address

PO Box 365
Killen, AL 35645-0365
Phone (256) 757-5012

Other identifiers 1

IdentifierTypeStateIssuer
510-03866OtherALBLUE CROSS

National Provider Directory

National Provider Directory

Locations

207 J C Mauldin Hwy
Killen, AL 35645
Phone (256) 757-5012

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1477634459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 365",
            "city": "KILLEN",
            "state": "AL",
            "postal_code": "356450365",
            "telephone_number": "256-757-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 J C MAULDIN HWY",
            "city": "KILLEN",
            "state": "AL",
            "postal_code": "356459146",
            "telephone_number": "256-757-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KILLEN CTR STAR RESCUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "GOLLIVER",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "256-757-5012"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AL",
            "license": "777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "510-03866",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Killen, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.