MEDICARE: STAR MED CONSULTING 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	332900000X	Non-Pharmacy Dispensing Site	9009	NV

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
2	2990225	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1649316258
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAR MED CONSULTING LLC

Provider Business Mailing Address
First Line	:	PO BOX 530880
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89053-0880
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2645 W HORIZON RIDGE PKWY
Second Line	:	STE 120
City	:	HENDERSON
State	:	NV
Zip	:	89052-2898
Country	:	US
Telephone Number	:	702-648-9998
Fax Number	:	702-648-9991

Authorized Official
Title or Position	:	OWNER STARMED CONSULTING
Name	:	S WILLIAM PIERCE
Credential	:
Telephone Number	:	702-648-9998

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	07/15/2008

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Directions to “STAR MED CONSULTING LLC ” Practice Location

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