Canyon State Ambulance

LBN: Lifestar Llc
Canyon State Ambulance is an health care organization with primary practice located at 1014 S Westerly , Payson AZ 85541. The organization recently has only one registered license in Transportation Services / Ambulance, which is considered as the primary health care specialty. Lifestar Llc can be contacted via phone (928) 474-2831, or through Vassallo, Ralph J via phone (602) 437-6620.

Contact Information

Primary practice address
1014 S Westerly Payson AZ 85541
Phone: (928) 474-2831
Fax: (928) 474-6188
Website:
Map and Directions
Authorized official contact:
Name: Vassallo, Ralph J
Phone: (602) 437-6620

Health care specialties

SpecialtyCodeLicense #State
Transportation Services / Ambulance 341600000X 58 Arizona

Profile Details

NPI number 1699752998
LBN Legal business name Lifestar Llc
DBA Doing business as Canyon State Ambulance
Authorized official Vassallo, Ralph J
Entity Organization
Organization subpart 1 No
Enumeration date Dec 28th, 2005
Last updated Nov 3rd, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699752998 NPPES
Arizona Other 590015162 RR MEDICARE
Arizona Other AZ0152310 RR MEDICARE
Arizona MEDICAID 620949 RR MEDICARE

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