Provider Demographics
NPI:1609263292
Name:GOLD STAR SERVICES
Entity Type:Organization
Organization Name:GOLD STAR SERVICES
Other - Org Name:GOLD STAR HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-419-2800
Mailing Address - Street 1:4500 N LINCOLN BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-3402
Mailing Address - Country:US
Mailing Address - Phone:405-419-2800
Mailing Address - Fax:405-424-6507
Practice Address - Street 1:4500 N LINCOLN BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-3402
Practice Address - Country:US
Practice Address - Phone:405-419-2800
Practice Address - Fax:405-424-6507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-21
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKHC8045251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health