Provider Demographics
NPI:1407595457
Name:BLUE STAR HOME HEALTH CARE , LLC
Entity Type:Organization
Organization Name:BLUE STAR HOME HEALTH CARE , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:ADAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-805-0095
Mailing Address - Street 1:PO BOX 232
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-0232
Mailing Address - Country:US
Mailing Address - Phone:614-805-0095
Mailing Address - Fax:
Practice Address - Street 1:1053 BLACKBERRY LN
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-7072
Practice Address - Country:US
Practice Address - Phone:614-805-0095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-28
Last Update Date:2022-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health