Provider Demographics
NPI:1497505929
Name:FIVE STAR MEDICAL SUPPLIES TRADER LLC
Entity Type:Organization
Organization Name:FIVE STAR MEDICAL SUPPLIES TRADER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:SHABBIR HAIDER
Authorized Official - Last Name:ZAIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-718-0407
Mailing Address - Street 1:11103 WEST AVE STE 125
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1338
Mailing Address - Country:US
Mailing Address - Phone:210-718-0407
Mailing Address - Fax:
Practice Address - Street 1:11103 WEST AVE STE 125
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-1338
Practice Address - Country:US
Practice Address - Phone:210-718-0407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies