Organization Active NPI

All Star Medi'Van LLC

  • Secured Medical Transport (VAN)
  • Killeen, TX
National Provider Identifier
1609387885
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Secured Medical Transport (VAN)Taxonomy code 343800000X
Legal business name
ALL STAR MEDI'VAN LLC
Practice address
6307 Cordillera Dr
Killeen, TX 76549-6895
Phone
(847) 401-9851
NPI assigned
Oct 16, 2017
Last updated
Dec 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Authorized official

Name
Elisa Renee St George
Title
Owner
Phone
(847) 401-9851

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Secured Medical Transport (VAN) 343800000X NU Primary
Non-emergency Medical Transport (VAN) 343900000X S53221679893 IL

Addresses

Primary practice location

6307 Cordillera Dr
Killeen, TX 76549-6895

Mailing address

6307 Cordillera Dr
Killeen, TX 76549-6895
Phone (847) 401-9851

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1609387885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6307 CORDILLERA DR",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765496895",
            "telephone_number": "847-401-9851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6307 CORDILLERA DR",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765496895",
            "telephone_number": "847-401-9851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL STAR MEDI'VAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-16",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "ST GEORGE",
        "authorized_official_first_name": "ELISA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-401-9851"
    },
    "taxonomies": [
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "IL",
            "license": "S53221679893",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.