Provider Demographics
NPI:1659580439
Name:NURSES STATION STAR
Entity Type:Organization
Organization Name:NURSES STATION STAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:FAGRE
Authorized Official - Last Name:CHAFLOQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-241-0255
Mailing Address - Street 1:1073 W BROAD ST STE 212A
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4612
Mailing Address - Country:US
Mailing Address - Phone:703-241-0255
Mailing Address - Fax:703-241-0059
Practice Address - Street 1:1073 W BROAD ST STE 212A
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4612
Practice Address - Country:US
Practice Address - Phone:703-241-0255
Practice Address - Fax:703-241-0059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health