Organization
LIFESTAR RESPONSE OF ALABAMA
Active
Other names
CARE AMBULANCE
Organization subpart
No
Provider details
NPI number
Authorized official
JON COLIN (CEO)
(973) 812-7271
Entity
Organization
Contact information
Practice address
4745 HUGH HOWELL RD., TUCKER, GA 30085-5007
(631) 447-2800
(631) 447-2808
Mailing address
BOX 530492, ATLANTA, GA 30353-0492
(631) 447-2800
(631) 447-2808
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
106-08
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400391507A
—
GA
Enumeration date
11/23/2005
Last updated
07/30/2009
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