Provider Demographics
NPI:1437900891
Name:SUNSTAR TRANSTATIONLLC
Entity type:Organization
Organization Name:SUNSTAR TRANSTATIONLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSPORTATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWNELLA
Authorized Official - Middle Name:L
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-217-1254
Mailing Address - Street 1:1634 WINFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-2767
Mailing Address - Country:US
Mailing Address - Phone:574-217-1254
Mailing Address - Fax:
Practice Address - Street 1:1634 WINFIELD AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-2767
Practice Address - Country:US
Practice Address - Phone:574-217-1254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNSTAR TRANSTATION LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)