LIFESTAR LLC NPI 1699752998

NPI Information

  • NPI: 1699752998
  • Provider Name: LIFESTAR LLC
  • Classification: Ambulance - 341600000X
  • Entity Type: Organization
  • Doing Business As: CANYON STATE AMBULANCE
  • Address: 1014 S WESTERLY
    PAYSON, AZ
    ZIP 85541
  • Phone: (928) 474-2831

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NPI Details

LIFESTAR LLC is an ambulance in Payson, AZ. The provider is an emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane). LIFESTAR LLC NPI is 1699752998. The provider is registered as an organization entity type.
The provider Is Doing Business As Canyon State Ambulance.

The provider's business location address is:

1014 S WESTERLY
PAYSON, AZ
ZIP 85541
Phone: (928) 474-2831
Fax: (928) 474-6188

The provider's authorized official is Ralph J Vassallo .
The authorized official title is Vice President Of Billing Services and has the following contact phone number (602) 437-6620.

The enumeration date for this NPI number is 12/28/2005 and was last updated on 11/3/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1341600000XAmbulance58ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1X65940MEDICARE UPIN
2590015162OTHERARIZONARR MEDICARE
3AZ0152310OTHERARIZONABCBS
4620949MEDICAIDARIZONA
5Z67784MEDICARE ID-TYPE UNSPECIFIEDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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