Provider Demographics
NPI:1790411940
Name:BRIGHTSTAR FL/AL OPERATIONS, LLC
Entity Type:Organization
Organization Name:BRIGHTSTAR FL/AL OPERATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PALLASCHKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-856-7663
Mailing Address - Street 1:8245 SPANISH FORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORT
Mailing Address - State:AL
Mailing Address - Zip Code:36527-5245
Mailing Address - Country:US
Mailing Address - Phone:251-405-6451
Mailing Address - Fax:251-405-6099
Practice Address - Street 1:8245 SPANISH FORT BLVD
Practice Address - Street 2:
Practice Address - City:SPANISH FORT
Practice Address - State:AL
Practice Address - Zip Code:36527-5245
Practice Address - Country:US
Practice Address - Phone:251-405-6451
Practice Address - Fax:251-405-6099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health