Provider Demographics
NPI:1508556820
Name:MORNING STAR MEDICAL ENTERPRISES LLC
Entity Type:Organization
Organization Name:MORNING STAR MEDICAL ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMOKAYODE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNDIMU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-234-4362
Mailing Address - Street 1:1027 PARK HOLLOW WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-3869
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1027 PARK HOLLOW WAY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-3869
Practice Address - Country:US
Practice Address - Phone:678-234-4362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-10
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies