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General NPI Number Information
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NPI Number | 1346959558
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Entity Type | Organization
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Legal Business Name | 5 STARS DME LLC
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Dates
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Enumeration Date | 11/16/2022
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 501 MARINA CT STE 1A
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City | LAREDO
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State | TX
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Zip | 78046-4065
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Country | US
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Telephone | 956-701-3509
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Fax | 956-701-3511
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Provider Business Mailing Address
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Address Line | 501 MARINA CT STE 1A
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City | LAREDO
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State | TX
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Zip | 78046-4065
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Country | US
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Telephone | 956-701-3509
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Fax | 956-701-3511
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LUIS VICENTE ORTIZ
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Credential |
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Telephone | 956-701-3509
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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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