Provider Demographics
NPI:1225781420
Name:BRIGHTSTAR SCOTTSDALE OPERATIONS, LLC
Entity Type:Organization
Organization Name:BRIGHTSTAR SCOTTSDALE OPERATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PALLASCHKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-856-7663
Mailing Address - Street 1:1125 TRI STATE PKWY STE 700
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-9177
Mailing Address - Country:US
Mailing Address - Phone:847-693-2003
Mailing Address - Fax:
Practice Address - Street 1:17015 N SCOTTSDALE RD STE 115
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-5873
Practice Address - Country:US
Practice Address - Phone:480-302-5139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIGHTSTAR GROUP HOLDINGS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-28
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health