Healthcare Provider Details
I. General information
NPI: 1427994698
Provider Name (Legal Business Name): PROSTAR SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
219 COOLEYS CREST LN
INMAN SC
29349-4341
US
IV. Provider business mailing address
219 COOLEYS CREST LN
INMAN SC
29349-4341
US
V. Phone/Fax
- Phone: 864-325-9284
- Fax:
- Phone: 864-325-9284
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171W00000X |
| Taxonomy | Contractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALBERT
BROWN
JR.
Title or Position: OWNER
Credential:
Phone: 864-325-9284