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General NPI Number Information
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NPI Number | 1215261854
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Entity Type | Organization
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Legal Business Name | STAARS - WASHINGTON
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Dates
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Enumeration Date | 09/30/2009
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Last Update Date | 01/27/2010
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Provider Practice Location Address
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Address Line | 411 W MAIN ST SUITE 106
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City | WASHINGTON
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State | NC
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Zip | 27889-4831
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Country | US
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Telephone | 919-269-6560
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Fax | 919-269-6564
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Provider Business Mailing Address
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Address Line | 375 E 3RD ST SUITE 202
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City | WENDELL
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State | NC
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Zip | 27591-9708
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Country | US
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Telephone | 919-365-9096
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Fax | 919-365-9097
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. SHARON EVETTE MOORE
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Credential |
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Telephone | 919-365-9096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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