LIFE STAR HEALTHCARE LLC (NPI# 1760635700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760635700 |
| Entity Type | Organization |
| Organization Name | LIFE STAR HEALTHCARE LLC |
| Practice Address |
111 Glendale St Jackson TN 38301-5101 |
| Practice Telephone | 6159741632 |
| Mailing Telephone | 6159741632 |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2008-11-03 |
| Authorized Official Name | MR. MICHAEL DOUGLAS HENDERSON (OWNER) |
| Authorized Official Telephone | 6159741632 |
| Authorized Official Credential | EMT-PARAMEDIC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
EMT0000030252 | TN | Transportation Services |
| Street Address |
111 GLENDALE ST |
| City | JACKSON |
| State | TN |
| Zip Code | 38301-5101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634696 | Lindsey Crowder | Social Worker | 127 Mccowat Street, Jackson, TN 38301 | 2020-09-21 |
| 1366928087 | Primary Care - South Limited | Clinic/Center | 1385 South Highland Ave, Suite B-1, Jackson, TN 38301 | 2018-07-16 |
| 1629592522 | Tlc Home Care Services, LLC | In Home Supportive Care | 39 Old Denmark Rd, Jackson, TN 38301 | 2017-08-01 |
| 1841730421 | Southern Hands Quality Care | In Home Supportive Care | 1298 N. Highland Avenue. Suite 14, Jackson, TN 38301 | 2017-03-02 |
| 1881044477 | Katie Mcmickin | Counselor | 163 Sunnyside Dr, Jackson, TN 38301 | 2016-06-15 |
| 1164815064 | Hailey Archer | Dietitian, Registered | 720 W. Forest Ave., Jackson, TN 38301 | 2015-03-17 |
| 1740673714 | Regina Tignor | Nurse Practitioner | 1410 Us Highway 70 Byp, Jackson, TN 38301 | 2015-03-13 |
| 1194114033 | Woman's Clinic | Obstetrics & Gynecology | 242 Coatsland, Jackson, TN 38301 | 2015-01-15 |
| 1659797702 | Worthy Walker Arrington | Nurse Practitioner | 720 West Forest Avenue, Jackson, TN 38301 | 2014-03-13 |
| 1669717302 | Lift Wellness Inc | General Practice | 101 Jackson Walk Plaza, Jackson, TN 38301 | 2012-12-06 |
| Find all providers in zip 38301 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
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| 1457627986 | Six Flags Great Adventure LLC | Ambulance | 1 Six Flags Blvd, Jackson, NJ 08527-5369 | 2012-03-29 |
| 1851601132 | County of Jackson | Ambulance | 260 Pattonsville Rd, Jackson, OH 45640-9452 | 2010-10-20 |
| 1003947953 | County of Teton | Ambulance | 40 E Pearl Ave, Jackson, WY 83001 | 2007-03-09 |
| 1770686610 | Village of Jackson | Ambulance | W204n16722 Jackson Dr, Jackson, WI 53037-9796 | 2006-09-06 |
| 1831206713 | Jackson Emergency Transport Service, LLC | Ambulance | 210 S Kimball Ave, Jackson, AL 36545-2726 | 2006-08-24 |
| 1164786257 | Jackson-madison County General Hospital | Ambulance | 620 Skyline Dr, Jackson, TN 38301-3923 | 2012-07-03 |
| Find all providers in JACKSON | ||||
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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.