Provider Demographics
NPI:1235560541
Name:FIVE STAR CARE INC.
Entity Type:Organization
Organization Name:FIVE STAR CARE INC.
Other - Org Name:GR CURE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:REDWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-641-8880
Mailing Address - Street 1:108-B NORTH MAIN
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TX
Mailing Address - Zip Code:77535
Mailing Address - Country:US
Mailing Address - Phone:936-681-8335
Mailing Address - Fax:936-681-8320
Practice Address - Street 1:108-B NORTH MAIN
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TX
Practice Address - Zip Code:77535
Practice Address - Country:US
Practice Address - Phone:936-681-8335
Practice Address - Fax:936-681-8320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-12
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX289203336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146864Medicaid