Organization
LIFE STAR HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL DOUGLAS HENDERSON EMT-PARAMEDIC (OWNER)
(615) 974-1632
Entity
Organization
Contact information
Practice address
111 GLENDALE ST, JACKSON, TN 38301-5101
(615) 974-1632
Mailing address
111 GLENDALE ST, JACKSON, TN 38301-5101
(615) 974-1632
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
EMT0000030252
TN
Other
Enumeration date
11/03/2008
Last updated
11/03/2008
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