MEDICARE: STAR WHOLESALERS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1538588694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAR WHOLESALERS LLC

Provider Business Mailing Address
First Line	:	4295 AUGUSTA RD
Second Line	:	SUITE 901
City	:	GREENVILLE
State	:	SC
Zip	:	29605-1320
Country	:	US
Telephone Number	:	404-906-6722
Fax Number	:

Provider Business Practice Location Address
First Line	:	4295 AUGUSTA RD
Second Line	:	SUITE 901
City	:	GREENVILLE
State	:	SC
Zip	:	29605-1320
Country	:	US
Telephone Number	:	404-906-6722
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. MOHAN THAKARE
Credential	:
Telephone Number	:	404-906-6722

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	04/15/2014

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Directions to “STAR WHOLESALERS LLC ” Practice Location

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