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Contact Information

LIFESTAR LLC
1014 S WESTERLY
PAYSON, AZ85541
 Phone: 928-474-2831
 Fax: 928-474-6188
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ambulance

341600000X 59 Ambulance Service Provider
Indicates primary specialty

NPI Profile & details for LIFESTAR LLC

NPI Number 1699752998
LBN Legal business name LIFESTAR LLC
Authorized official RALPH VASSALLO - (VICE PRESIDENT OF BILLING SERVICES)
Entity Organization
Organization subpart 1 No
Enumeration date 12/28/2005
Last updated 11/03/2009 - About 17 years ago
Identifiers
AZ License # 58
AZ Medicaid 620949
AZ Other AZ0152310 BCBS
AZ Other 590015162 RR MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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