MEDICARE: 5 STAR TRANSCARE SYSTEMS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	PUC1791-C	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164639639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	5 STAR TRANSCARE SYSTEMS LLC

Provider Business Mailing Address
First Line	:	1784 HOOHULU ST
Second Line	:
City	:	PEARL CITY
State	:	HI
Zip	:	96782-1813
Country	:	US
Telephone Number	:	808-456-8457
Fax Number	:	808-455-2599

Provider Business Practice Location Address
First Line	:	1784 HOOHULU ST
Second Line	:
City	:	PEARL CITY
State	:	HI
Zip	:	96782-1813
Country	:	US
Telephone Number	:	808-456-8457
Fax Number	:	808-455-2599

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ADRIAN WONG
Credential	:
Telephone Number	:	808-456-8457

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	08/22/2020

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