Provider Demographics
NPI:1407147648
Name:STARDUST LLC
Entity Type:Organization
Organization Name:STARDUST LLC
Other - Org Name:ROSE BILLING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KARINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SARGSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-955-5150
Mailing Address - Street 1:3008 W BURBANK BLVD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2311
Mailing Address - Country:US
Mailing Address - Phone:818-955-5150
Mailing Address - Fax:818-955-5788
Practice Address - Street 1:3008 W BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2311
Practice Address - Country:US
Practice Address - Phone:818-955-5150
Practice Address - Fax:818-955-5788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty