Provider Demographics
NPI:1174797534
Name:STAR MEDICAL TRANSPORTATION COMPANY
Entity type:Organization
Organization Name:STAR MEDICAL TRANSPORTATION COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-559-1111
Mailing Address - Street 1:1884 TECHNY CT
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-5474
Mailing Address - Country:US
Mailing Address - Phone:847-559-1111
Mailing Address - Fax:
Practice Address - Street 1:1884 TECHNY CT
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-5474
Practice Address - Country:US
Practice Address - Phone:847-559-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)