MEDICARE: ALL STAR SUPPORT SERVICES, 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	:	1669247326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL STAR SUPPORT SERVICES, LLC

Provider Business Mailing Address
First Line	:	1520 STONEMOSS CT STE 303
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-5731
Country	:	US
Telephone Number	:	757-651-6644
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 STONEMOSS CT STE 303
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-5731
Country	:	US
Telephone Number	:	757-651-6644
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MARC KEITH WRIGHT
Credential	:
Telephone Number	:	757-651-6644

Provider Enumeration Date	:	11/21/2023
Last Update Date	:	11/21/2023

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Directions to “ALL STAR SUPPORT SERVICES, LLC ” Practice Location

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