MEDICARE: CARE STAR HEALTHCARE SERVICES

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	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1871217067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE STAR HEALTHCARE SERVICES

Provider Business Mailing Address
First Line	:	3269 N HENRY BLVD
Second Line	:
City	:	STOCKBRIDGE
State	:	GA
Zip	:	30281-4446
Country	:	US
Telephone Number	:	470-854-8879
Fax Number	:

Provider Business Practice Location Address
First Line	:	3269 N HENRY BLVD
Second Line	:
City	:	STOCKBRIDGE
State	:	GA
Zip	:	30281-4446
Country	:	US
Telephone Number	:	470-854-8879
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BRANDON BROWN
Credential	:
Telephone Number	:	470-854-8879

Provider Enumeration Date	:	09/30/2022
Last Update Date	:	09/30/2022

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