Life Star Healthcare LLC
Ambulance, Land Transport in Jackson, TN. Organization (NPI-2).
NPI number1760635700
StatusActive
Last updated in NPPESNov 3, 2008
Details
- NPI
- 1760635700
- Entity type
- Organization (NPI-2)
- Legal business name
- Life Star Healthcare LLC
- Organization subpart
- No
- Enumeration date
- Nov 3, 2008
- Last updated
- Nov 3, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3416L0300X | Ambulance, Land Transport | EMT0000030252 | TN | Yes |
Practice location
111 Glendale StJackson, TN 38301-5101
Phone 615-974-1632
Mailing address
111 Glendale StJackson, TN 38301-5101
Phone 615-974-1632
Authorized official
Michael Douglas Henderson
Owner
6159741632
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