Organization
LIFESTAR AMBULETTE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RALPH J. VASSALLO JR. (SENIOR VICE PRESIDENT)
(602) 957-2800
Entity
Organization
Contact information
Practice address
1501 W FOUNTAINHEAD PKWY STE 650, TEMPE, AZ 85282-1864
(602) 957-2800
(602) 275-7886
Mailing address
1501 W FOUNTAINHEAD PKWY STE 650, TEMPE, AZ 85282-1864
(602) 957-2800
(602) 275-7886
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
333435
—
AZ
Enumeration date
04/20/2007
Last updated
08/22/2020
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