Provider Demographics
NPI:1871978437
Name:NORTHSTAR MEDIC ONE
Entity type:Organization
Organization Name:NORTHSTAR MEDIC ONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-560-3084
Mailing Address - Street 1:421 IRONWOOD ST
Mailing Address - Street 2:PO BOX 294
Mailing Address - City:OROVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98844-9239
Mailing Address - Country:US
Mailing Address - Phone:509-560-3084
Mailing Address - Fax:
Practice Address - Street 1:614 FIR ST
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:WA
Practice Address - Zip Code:98844-9796
Practice Address - Country:US
Practice Address - Phone:509-560-3084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAMB.ES.605864533416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport