LIFESTAR AMBULANCE SERVICE INC (NPI# 1760496558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760496558 |
| Entity Type | Organization |
| Organization Name | LIFESTAR AMBULANCE SERVICE INC |
| Practice Address |
940 No Elm St Centralia IL 62801 |
| Mailing Address |
940 No Elm St Po Box 1838 Centralia IL 62801 |
| Practice Telephone | 6185322474 |
| Practice Fax Number | 6185327795 |
| Mailing Telephone | 6185322474 |
| Mailing Fax Number | 6185327795 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROGER D CAMPBELL (PRESIDENT) |
| Authorized Official Telephone | 6185322474 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 341600000X | Ambulance | 5225 | IL | Transportation Services |
| N | 341600000X | Ambulance | 4880 | IL | Transportation Services |
| Y | 341600000X | Ambulance | 3633 | IL | Transportation Services |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Lifestar Ambulance Service Inc. | 300 North Main St, Emporia, Virginia 23847 |
| Street Address |
940 NO ELM ST |
| City | CENTRALIA |
| State | IL |
| Zip Code | 62801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996151 | Matthew Crawford | Counselor | 904 E Martin Luther King Dr, Centralia, IL 62801 | 2019-08-08 |
| 1588130314 | Kennah White | Counselor | 904 E. Mlk Drive, Centralia, IL 62801 | 2018-10-19 |
| 1245721588 | Lindsey Nicole Fogliasso | Counselor | 904 East Mlk Dr., Centralia, IL 62801 | 2018-05-22 |
| 1629573365 | Prabhat Shrestha | Student in an Organized Health Care Education/Training Program | 605 Sable Drive, Centralia, IL 62801 | 2018-03-26 |
| 1619496098 | Whitney Rathmann | Speech-Language Pathologist | 224 South Locust, Centralia, IL 62801 | 2017-09-17 |
| 1376082685 | Athena A Smith | Counselor | 904 E. Martin Luther King Dr, Centralia, IL 62801 | 2017-02-20 |
| 1447704069 | Meghan Branch | Counselor | 904 Martin Luther King Dr, Centralia, IL 62801 | 2016-08-11 |
| 1568820637 | Midland Area Agency On Aging | Case Management | 434 S Poplar Street, Centralia, IL 62801 | 2016-02-04 |
| 1104201714 | Keri Douglas | Nurse Practitioner | 1054 M. L. King Drive #125, Centrailia, IL 62801 | 2015-07-24 |
| 1215331509 | Melissa Dane | Counselor | 904 E Martin Luther King Dr., Centralia, IL 62801 | 2014-10-15 |
| Find all providers in zip 62801 | ||||
| Taxonomy Code | 341600000X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane). |
| Notes: Source: Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 37. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487608055 | Lifestar Ambulance Service,inc. | Ambulance | 940 N Elm St, Centralia, IL 62801-2326 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750980058 | Ivan V Knight | Ambulance | 322 Campbell Ave, Calumet City, IL 60409-2011 | 2020-10-19 |
| 1366064057 | Morris Fire & Ambulance Protection District | Ambulance | 2301 Ashton Rd, Morris, IL 60450-8615 | 2020-05-15 |
| 1821624966 | Covenant Health Ambulance Service, Inc | Ambulance | 1619b Weid Rd, Elgin, IL 60123-5825 | 2020-03-20 |
| 1053942920 | Village of Robbins | Ambulance | 3327 W 137th Street, Robbins, IL 60472-1636 | 2020-01-30 |
| 1093372187 | Vital Ambulance Services LLC | Ambulance | 18781 90th Ave., Suite A, Mokena, IL 60448 | 2019-05-23 |
| 1831668458 | Midway Ems | Ambulance | 5155 Torque Rd # B, Loves Park, IL 61111-7144 | 2018-11-14 |
| 1336637248 | Paramedic Services of Illinois, Inc. | Ambulance | 1222 W. Veterans Parkway, Yorkville, IL 60560-4728 | 2018-04-26 |
| 1255832564 | Lifeguard Ambulance Service of Illinois Inc. | Ambulance | 219 W Jackson St, Macomb, IL 61455 | 2018-02-22 |
| 1891293288 | Hamel Fire Protection District | Ambulance | 401 N Old Us Route 66, Hamel, IL 62046-1071 | 2018-01-31 |
| 1144761503 | Ah, LLC | Ambulance | 741 N Main St, Manteno, IL 60950-1254 | 2017-03-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.