Provider Demographics
NPI:1235433483
Name:ALL STAR ORTHOPEDIC & MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:ALL STAR ORTHOPEDIC & MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YEFIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SOKIRYANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-364-6424
Mailing Address - Street 1:13644 NEUTRON RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-4410
Mailing Address - Country:US
Mailing Address - Phone:469-364-6424
Mailing Address - Fax:469-364-6423
Practice Address - Street 1:13644 NEUTRON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-4410
Practice Address - Country:US
Practice Address - Phone:469-364-6424
Practice Address - Fax:469-364-6423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies