Healthcare Provider Details

I. General information

NPI: 1417748179
Provider Name (Legal Business Name): STARS MEDICAL AND PSYCHIATRIC URGENT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4330 JOHNS CREEK PKWY STE 400
SUWANEE GA
30024-6120
US

IV. Provider business mailing address

4330 JOHNS CREEK PKWY STE 400
SUWANEE GA
30024-6120
US

V. Phone/Fax

Practice location:
  • Phone: 470-253-1350
  • Fax: 470-253-1349
Mailing address:
  • Phone: 470-253-1350
  • Fax: 470-253-1349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISS ILUNGA MULUMBA
Title or Position: MD/CEO
Credential: MD
Phone: 470-253-1350