Healthcare Provider Details

I. General information

NPI: 1730907122
Provider Name (Legal Business Name): 5IVE STARS ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1471 STATE ST
SCHENECTADY NY
12304-2913
US

IV. Provider business mailing address

1471 STATE ST
SCHENECTADY NY
12304-2913
US

V. Phone/Fax

Practice location:
  • Phone: 518-280-1554
  • Fax: 518-280-2144
Mailing address:
  • Phone: 518-280-1554
  • Fax: 518-280-2144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. USMAN SHEIKH WAQAR
Title or Position: SECRETARY
Credential:
Phone: 518-280-1554