Provider Demographics
NPI:1447406111
Name:STAR MEDICAL, INC
Entity Type:Organization
Organization Name:STAR MEDICAL, INC
Other - Org Name:ETHOS THERAPY SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BYRNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-861-8612
Mailing Address - Street 1:930 HARVEST DR STE 400
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1976
Mailing Address - Country:US
Mailing Address - Phone:888-861-8612
Mailing Address - Fax:
Practice Address - Street 1:930 HARVEST DR STE 400
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1976
Practice Address - Country:US
Practice Address - Phone:888-861-8612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6168960001Medicare NSC