Provider Demographics
NPI:1659430650
Name:STAR MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:STAR MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARTUR
Authorized Official - Middle Name:
Authorized Official - Last Name:MANASARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-987-1377
Mailing Address - Street 1:6363 TAFT ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-5962
Mailing Address - Country:US
Mailing Address - Phone:954-987-1377
Mailing Address - Fax:
Practice Address - Street 1:6363 TAFT ST
Practice Address - Street 2:SUITE 104
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-5962
Practice Address - Country:US
Practice Address - Phone:954-987-1377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies