Provider Demographics
NPI:1164639639
Name:5 STAR TRANSCARE SYSTEMS LLC
Entity Type:Organization
Organization Name:5 STAR TRANSCARE SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-456-8457
Mailing Address - Street 1:1784 HOOHULU ST
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-1813
Mailing Address - Country:US
Mailing Address - Phone:808-456-8457
Mailing Address - Fax:808-455-2599
Practice Address - Street 1:1784 HOOHULU ST
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-1813
Practice Address - Country:US
Practice Address - Phone:808-456-8457
Practice Address - Fax:808-455-2599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPUC1791-C343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI54601201Medicaid