Provider Demographics
NPI:1285217273
Name:5 STAR BUSINESS GROUP LLC
Entity Type:Organization
Organization Name:5 STAR BUSINESS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:TAJONG
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:164-633-8892
Mailing Address - Street 1:14511 LAYHILL RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-1914
Mailing Address - Country:US
Mailing Address - Phone:240-264-7609
Mailing Address - Fax:866-613-6973
Practice Address - Street 1:14511 LAYHILL RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-1914
Practice Address - Country:US
Practice Address - Phone:240-264-7609
Practice Address - Fax:866-613-6973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health