Healthcare Provider Details
I. General information
NPI: 1689173338
Provider Name (Legal Business Name): STAR MARKETING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/08/2018
Last Update Date: 02/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 E BIRCH ST STE 2
CALEXICO CA
92231-5925
US
IV. Provider business mailing address
251 W MAIN ST STE G
BRAWLEY CA
92227-2202
US
V. Phone/Fax
- Phone: 760-618-9285
- Fax: 760-618-9240
- Phone: 760-351-9415
- Fax: 760-618-9240
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
PHILIP
KUBECK
Title or Position: DIRECTOR OF ADMINISTRATION
Credential:
Phone: 760-618-9285