Healthcare Provider Details
I. General information
NPI: 1376372367
Provider Name (Legal Business Name): 5 STAR HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/29/2024
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1490 W 121ST AVE STE 103
WESTMINSTER CO
80234-3497
US
IV. Provider business mailing address
1490 W 121ST AVE STE 103
WESTMINSTER CO
80234-3497
US
V. Phone/Fax
- Phone: 303-226-5600
- Fax: 702-386-0064
- Phone: 303-226-5600
- Fax: 702-386-0064
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083A0300X |
| Taxonomy | Addiction Medicine (Preventive Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
NZHDEH
KARAKHANYAN
Title or Position: OWNER
Credential:
Phone: 303-226-5600