Healthcare Provider Details

I. General information

NPI: 1336032945
Provider Name (Legal Business Name): DAYSTAR FAMILY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 W KEMPER RD
CINCINNATI OH
45240-1764
US

IV. Provider business mailing address

453 SMILEY AVE
SPRINGDALE OH
45246-2217
US

V. Phone/Fax

Practice location:
  • Phone: 513-429-3289
  • Fax: 513-928-7689
Mailing address:
  • Phone: 513-628-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: EDWIN OKOH OKAI
Title or Position: C E O
Credential:
Phone: 513-628-7111