MEDICARE: 5 STAR HOME CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1285078279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	5 STAR HOME CARE LLC

Provider Business Mailing Address
First Line	:	9100 BEACH
Second Line	:	SUITE 1308
City	:	MARGATE CITY
State	:	NJ
Zip	:	08402-2488
Country	:	US
Telephone Number	:	215-350-5700
Fax Number	:	215-350-5700

Provider Business Practice Location Address
First Line	:	9100 BEACH
Second Line	:	SUITE 1308
City	:	MARGATE CITY
State	:	NJ
Zip	:	08402-2488
Country	:	US
Telephone Number	:	215-350-5700
Fax Number	:	215-350-5700

Authorized Official
Title or Position	:	MANAGER
Name	:	HILARY GILLMAN
Credential	:
Telephone Number	:	215-350-5700

Provider Enumeration Date	:	04/22/2013
Last Update Date	:	06/24/2013

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