Provider Demographics
NPI:1558048629
Name:DAYSTAR HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:DAYSTAR HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:OJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-361-7871
Mailing Address - Street 1:8952 CONGRESS PL
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4726
Mailing Address - Country:US
Mailing Address - Phone:120-236-1787
Mailing Address - Fax:
Practice Address - Street 1:8952 CONGRESS PL
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-4726
Practice Address - Country:US
Practice Address - Phone:120-236-1787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health