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General NPI Number Information
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NPI Number | 1679168819
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Entity Type | Organization
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Legal Business Name | NSTAR HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 03/09/2021
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 132 STANLEY CT STE G
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-9061
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Country | US
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Telephone | 470-292-3306
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Fax | 470-292-3306
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Provider Business Mailing Address
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Address Line | 132 STANLEY CT STE G
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-9061
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Country | US
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Telephone | 470-292-3306
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Fax | 470-292-3306
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ALFRED FUBUH
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Credential | MBA
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Telephone | 404-437-3685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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