All Star Medivan INC
Non-emergency Medical Transport (VAN) in Waukegan, IL. Organization (NPI-2).
NPI number1912122425
StatusActive
Last updated in NPPESMay 12, 2011
Details
- NPI
- 1912122425
- Entity type
- Organization (NPI-2)
- Legal business name
- All Star Medivan INC
- Organization subpart
- No
- Enumeration date
- Apr 17, 2007
- Last updated
- May 12, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 343900000X | Non-emergency Medical Transport (VAN) | – | – | Yes |
Practice location
2734 Blanchard RdWaukegan, IL 60087-3541
Phone 847-672-9292
Mailing address
2734 Blanchard RdWaukegan, IL 60087-3541
Authorized official
Elisa Renee St George
President
8474019851
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