Provider Demographics
NPI:1740419027
Name:TEC STAR MEDICAL SOLUTIONS
Entity Type:Organization
Organization Name:TEC STAR MEDICAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-242-3100
Mailing Address - Street 1:PO BOX 5204
Mailing Address - Street 2:
Mailing Address - City:PINE MOUNTAIN CLUB
Mailing Address - State:CA
Mailing Address - Zip Code:93222-5204
Mailing Address - Country:US
Mailing Address - Phone:661-242-3100
Mailing Address - Fax:661-242-3100
Practice Address - Street 1:15325 ACACIA WAY
Practice Address - Street 2:
Practice Address - City:FRAZIER PARK
Practice Address - State:CA
Practice Address - Zip Code:93222-5204
Practice Address - Country:US
Practice Address - Phone:661-242-3100
Practice Address - Fax:661-242-3100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management