Lifestar Ambulance, Inc.

Primary specialty

AmbulanceTaxonomy code 341600000X

License

063 Issued in MD

Legal business name

LIFESTAR AMBULANCE, INC.

Practice address

1024 S Tower Dr
Salisbury, MD 21804-6474

Phone

(410) 546-0809

Fax

(410) 860-5260

NPI assigned

Aug 13, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Jacqueline Tarr Fowler, RN, CRTT

Title

President

Phone

(410) 546-0809

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1912910092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 S TOWER DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046474",
            "telephone_number": "410-546-0809",
            "fax_number": "410-860-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 S TOWER DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046474",
            "telephone_number": "410-546-0809",
            "fax_number": "410-860-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTAR AMBULANCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "TARR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-546-0809",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, CRTT"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "MD",
            "license": "063",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "MD",
            "license": "2204",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00141515",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ambulance in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Ambulance in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.