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General NPI Number Information
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NPI Number | 1740607035
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Entity Type | Organization
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Legal Business Name | HEALTH STAR HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 03/25/2014
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Last Update Date | 07/18/2018
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Provider Practice Location Address
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Address Line | 2148 CHASEFORD LN
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City | POWDER SPRINGS
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State | GA
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Zip | 30127
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Country | US
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Telephone | 404-402-2902
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Fax | 678-224-5312
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Provider Business Mailing Address
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Address Line | 2148 CHASEFORD LN
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-5637
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Country | US
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Telephone | 404-402-2902
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Fax | 678-224-5312
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. ALPHONSE OKIBEDI
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Credential |
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Telephone | 404-402-2902
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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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