Provider Demographics
NPI:1710948344
Name:ALL-STAR MEDICAL, LLC
Entity Type:Organization
Organization Name:ALL-STAR MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:L
Authorized Official - Last Name:GARMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-533-1181
Mailing Address - Street 1:615 CLINTON AVE W UNIT 18947
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-5111
Mailing Address - Country:US
Mailing Address - Phone:256-533-1181
Mailing Address - Fax:256-533-4414
Practice Address - Street 1:2407 MEMORIAL PKWY SW
Practice Address - Street 2:SUITE 1
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5625
Practice Address - Country:US
Practice Address - Phone:256-534-5252
Practice Address - Fax:256-534-5253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL674332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL5496310002Medicare ID - Type Unspecified