Provider Demographics
NPI:1568908341
Name:STAR JAMMERZ INC
Entity Type:Organization
Organization Name:STAR JAMMERZ INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:BA
Authorized Official - Phone:515-263-0019
Mailing Address - Street 1:2340 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-5702
Mailing Address - Country:US
Mailing Address - Phone:515-263-0019
Mailing Address - Fax:515-263-0048
Practice Address - Street 1:2340 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-5702
Practice Address - Country:US
Practice Address - Phone:515-263-0019
Practice Address - Fax:515-263-0048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency