Provider Demographics
NPI:1467884981
Name:NORTHSTAR LLC
Entity Type:Organization
Organization Name:NORTHSTAR LLC
Other - Org Name:ACTIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:865-384-7251
Mailing Address - Street 1:1612 DOWNTOWN WEST BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5408
Mailing Address - Country:US
Mailing Address - Phone:865-357-8861
Mailing Address - Fax:865-357-8866
Practice Address - Street 1:1612 DOWNTOWN WEST BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5408
Practice Address - Country:US
Practice Address - Phone:865-357-8861
Practice Address - Fax:865-357-8866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332H00000XSuppliersEyewear Supplier
No332S00000XSuppliersHearing Aid Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier