Organization
ALL STAR MEDI'VAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISA RENEE ST GEORGE (OWNER)
(847) 401-9851
Entity
Organization
Contact information
Practice address
6307 CORDILLERA DR, KILLEEN, TX 76549-6895
(847) 401-9851
Mailing address
6307 CORDILLERA DR, KILLEEN, TX 76549-6895
(847) 401-9851
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
S53221679893
IL
Other
Enumeration date
10/16/2017
Last updated
12/06/2023
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