Lifestar Ambulance Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

480049 Issued in OH

Legal business name

LIFESTAR AMBULANCE INC.

Practice address

1402 Lagrange St
Toledo, OH 43608-2928

Phone

(419) 245-6210

Fax

(419) 245-7003

NPI assigned

Jul 18, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Cathy Nelson

Title

Director

Phone

(419) 245-6210

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555545600000",
    "number": "1578562047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 LAGRANGE ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082928",
            "telephone_number": "419-245-6210",
            "fax_number": "419-251-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 LAGRANGE ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082928",
            "telephone_number": "419-245-6210",
            "fax_number": "419-245-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTAR AMBULANCE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-18",
        "last_updated": "2019-04-18",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-245-6210",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OH",
            "license": "480049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590004782",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0627665",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Toledo, OH
• Providers in Toledo, OH by specialty
• Land Ambulance in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; 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.