# LIFESTAR RESPONSE OF ALABAMA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CARE AMBULANCE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871576793
- **Authorized official:** JON COLIN (CEO)
- **Authorized official phone:** (973) 812-7271

## Contact information

- **Practice address:** 4745 HUGH HOWELL RD., TUCKER, GA 30085-5007
- **Practice address phone:** (631) 447-2800
- **Practice address fax:** (631) 447-2808
- **Mailing address:** BOX 530492, ATLANTA, GA 30353-0492
- **Mailing address phone:** (631) 447-2800
- **Mailing address fax:** (631) 447-2808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 106-08 | GA | Yes |

## Other

- **Enumeration date:** 11/23/2005
- **Last updated:** 07/30/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 400391507A | — | GA |