Provider Demographics
NPI:1427225267
Name:FIVE STAR FA INC.
Entity Type:Organization
Organization Name:FIVE STAR FA INC.
Other - Org Name:FLOORING AMERICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SONBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-331-4613
Mailing Address - Street 1:10200 HICKMAN CT
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-5330
Mailing Address - Country:US
Mailing Address - Phone:515-331-4613
Mailing Address - Fax:515-331-0521
Practice Address - Street 1:10200 HICKMAN CT
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-5330
Practice Address - Country:US
Practice Address - Phone:515-331-4613
Practice Address - Fax:515-331-0521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
No171WV0202XOther Service ProvidersContractorVehicle ModificationsGroup - Single Specialty