MEDICARE: DAYSTAR SERVICES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	343900000X	Non-emergency Medical Transport (VAN)
3	347B00000X	Bus
4	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1174328991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAYSTAR SERVICES LLC

Provider Business Mailing Address
First Line	:	4513 COUNTY ROAD 12
Second Line	:
City	:	PROCTORVILLE
State	:	OH
Zip	:	45669-8304
Country	:	US
Telephone Number	:	740-861-9171
Fax Number	:

Provider Business Practice Location Address
First Line	:	1159 COUNTY ROAD 411
Second Line	:
City	:	PROCTORVILLE
State	:	OH
Zip	:	45669-9409
Country	:	US
Telephone Number	:	740-861-9171
Fax Number	:

Authorized Official
Title or Position	:	CEO/DIRECTOR
Name	:	TIMOTHY PORTER
Credential	:
Telephone Number	:	740-744-8730

Provider Enumeration Date	:	02/17/2025
Last Update Date	:	04/08/2025

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Directions to “DAYSTAR SERVICES LLC ” Practice Location

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