Provider Demographics
NPI:1659960235
Name:NORTH STAR ORAL TESTING CENTERS, LLC
Entity Type:Organization
Organization Name:NORTH STAR ORAL TESTING CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:CLAUDIUS
Authorized Official - Last Name:OGLESBY
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:856-655-8910
Mailing Address - Street 1:PO BOX 8383
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-0383
Mailing Address - Country:US
Mailing Address - Phone:856-655-8910
Mailing Address - Fax:
Practice Address - Street 1:3322 RIVER RD
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08105-4345
Practice Address - Country:US
Practice Address - Phone:833-869-9727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No251K00000XAgenciesPublic Health or Welfare
No251V00000XAgenciesVoluntary or Charitable