Provider Demographics
NPI:1144755000
Name:FIVE STAR MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:FIVE STAR MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:724-318-8793
Mailing Address - Street 1:422 MERCHANT ST
Mailing Address - Street 2:
Mailing Address - City:AMBRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15003-2405
Mailing Address - Country:US
Mailing Address - Phone:724-318-8793
Mailing Address - Fax:724-385-2078
Practice Address - Street 1:422 MERCHANT ST
Practice Address - Street 2:
Practice Address - City:AMBRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15003-2405
Practice Address - Country:US
Practice Address - Phone:724-318-8793
Practice Address - Fax:724-385-2078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-27
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014920207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty