=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770461568
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STAR HEALTHCARE SUPPLIES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/21/2025
-----------------------------------------------------
Last Update Date | 12/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10601 CLARENCE DR STE 250
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75033-3867
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-255-7800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1442 POTTSTOWN PIKE STE 272
-----------------------------------------------------
City | WEST CHESTER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19380-1271
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-255-7800
-----------------------------------------------------
Fax | 610-255-7800
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | NELSON LAMIZANA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 610-255-7800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------