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General NPI Number Information
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NPI Number | 1306461009
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Entity Type | Organization
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Legal Business Name | FIVE STARS CARE & SUPPLY INC
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Dates
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Enumeration Date | 06/09/2020
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 3435 BUFORD HWY STE D
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City | DULUTH
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State | GA
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Zip | 30096-3550
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Country | US
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Telephone | 678-878-3248
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Fax |
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Provider Business Mailing Address
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Address Line | 3435 BUFORD HWY STE D
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City | DULUTH
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State | GA
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Zip | 30096-3550
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Country | US
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Telephone | 678-878-3248
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JORGE NOYOLA
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Credential |
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Telephone | 678-878-3248
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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 |
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License Number State |
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