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General NPI Number Information
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NPI Number | 1871778175
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Entity Type | Organization
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Legal Business Name | M-STAR ENTERPRISES, INC
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Dates
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Enumeration Date | 01/04/2008
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 602 W KATHRYN ST
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City | NIXA
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State | MO
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Zip | 65714-8462
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Country | US
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Telephone | 417-725-6295
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Fax | 417-724-8450
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Provider Business Mailing Address
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Address Line | 602 W KATHRYN ST
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City | NIXA
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State | MO
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Zip | 65714-8462
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Country | US
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Telephone | 417-725-6295
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Fax | 417-724-8450
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID G MCCALLEY
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Credential |
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Telephone | 417-725-6295
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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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