Provider Demographics
NPI:1760991780
Name:A STAR COMPANION, INC
Entity Type:Organization
Organization Name:A STAR COMPANION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:EDOUARD
Authorized Official - Suffix:
Authorized Official - Credentials:HEALTH CARE PROVIDER
Authorized Official - Phone:305-328-9381
Mailing Address - Street 1:9628 NE 2ND AVE STE A4
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2748
Mailing Address - Country:US
Mailing Address - Phone:305-328-9381
Mailing Address - Fax:305-563-7027
Practice Address - Street 1:9628 N.E 2 AVE SUITE A4
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138
Practice Address - Country:US
Practice Address - Phone:305-834-9989
Practice Address - Fax:305-563-7027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLXXXXXXMedicaid
FL0002560084OtherHEALTH ASSURACE