| Organization Name: | LIFESTAR AMBULANCE SERVICE INC. |
| NPI Number: | 1114947322 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EDWARD FRANKLIN BRYANT (CO-OWNER) |
| Mailing Address: | 300 N Main St Emporia |
| State: | VA US |
| Postal Code: | 238471608 |
| Phone Number: | 4346341144 |
| Fax Number: | 4346341155 |
| NPI Enumeration Date: | 07/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |