Provider Demographics
NPI:1629676762
Name:GOLD STAR HOME HEALTHCARE INC
Entity Type:Organization
Organization Name:GOLD STAR HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-502-4638
Mailing Address - Street 1:8200 HUMBOLDT AVE S STE 101
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-1433
Mailing Address - Country:US
Mailing Address - Phone:651-502-4638
Mailing Address - Fax:
Practice Address - Street 1:8200 HUMBOLDT AVE S STE 101
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-1433
Practice Address - Country:US
Practice Address - Phone:651-502-4638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care