Provider Demographics
NPI:1407836885
Name:STARKEY MEDICAL
Entity Type:Organization
Organization Name:STARKEY MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:MERRITT
Authorized Official - Last Name:MEINHART
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:540-776-7630
Mailing Address - Street 1:PO BOX 4127
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-0127
Mailing Address - Country:US
Mailing Address - Phone:540-981-2706
Mailing Address - Fax:540-344-7154
Practice Address - Street 1:4903 STARKEY RD
Practice Address - Street 2:STE 300
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018
Practice Address - Country:US
Practice Address - Phone:540-776-7630
Practice Address - Fax:540-776-7631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-20
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C08847Medicare PIN