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General NPI Number Information
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NPI Number | 1033428107
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Entity Type | Organization
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Legal Business Name | STAR MEDICAL EQUIPMENT, INC.
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Dates
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Enumeration Date | 10/06/2010
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Last Update Date | 02/16/2011
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Provider Practice Location Address
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Address Line | 6661 CANYON DR SUITE D
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City | AMARILLO
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State | TX
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Zip | 79110-4343
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Country | US
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Telephone | 806-331-7778
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Fax | 806-331-7769
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Provider Business Mailing Address
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Address Line | 11912 SLIDE RD
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City | LUBBOCK
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State | TX
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Zip | 79424-7445
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Country | US
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Telephone | 806-762-6777
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Fax | 806-762-6780
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. GERALD LYNN WOOLAM JR.
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Credential |
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Telephone | 806-762-6777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1000445
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License Number State | TX
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