Provider Demographics
NPI:1568789998
Name:BROADSTAR INSTALLS LLC
Entity Type:Organization
Organization Name:BROADSTAR INSTALLS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:866-277-8144
Mailing Address - Street 1:4801 OLD WARWICK RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-4723
Mailing Address - Country:US
Mailing Address - Phone:866-277-8144
Mailing Address - Fax:804-201-8177
Practice Address - Street 1:4801 OLD WARWICK RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-4723
Practice Address - Country:US
Practice Address - Phone:866-277-8144
Practice Address - Fax:804-201-8177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-25
Last Update Date:2010-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty