Organization
LIFESTAR EMERGENCY MEDICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL L KRUEGER EMTP (PRESIDENT)
(262) 335-9950
Entity
Organization
Contact information
Practice address
279 S 17TH AVE STOP 8, WEST BEND, WI 53095-3001
(262) 335-9950
(262) 335-9720
Mailing address
PO BOX 113, WEST BEND, WI 53095-0113
(262) 335-9950
(262) 335-9720
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
6001359
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41353100
—
WI
05
—
41475100
—
WI
Enumeration date
11/18/2005
Last updated
08/13/2021
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