MEDICARE: NORTH STAR MEDICARE 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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1861333908
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH STAR MEDICARE LLC

Provider Business Mailing Address
First Line	:	195 S HIGHWAY 89
Second Line	:
City	:	NORTH SALT LAKE
State	:	UT
Zip	:	84054-2543
Country	:	US
Telephone Number	:	307-289-2158
Fax Number	:

Provider Business Practice Location Address
First Line	:	195 S HIGHWAY 89
Second Line	:
City	:	NORTH SALT LAKE
State	:	UT
Zip	:	84054-2543
Country	:	US
Telephone Number	:	307-289-2158
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	IRFAN KHAN
Credential	:
Telephone Number	:	307-289-2158

Provider Enumeration Date	:	04/02/2026
Last Update Date	:	04/02/2026

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Directions to “NORTH STAR MEDICARE LLC ” Practice Location

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