Provider Demographics
NPI:1023599982
Name:FIVE STAR MEDICAL STAFFING LLC
Entity type:Organization
Organization Name:FIVE STAR MEDICAL STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-947-6390
Mailing Address - Street 1:PO BOX 677
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-0677
Mailing Address - Country:US
Mailing Address - Phone:615-947-6390
Mailing Address - Fax:615-550-7171
Practice Address - Street 1:44 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-1583
Practice Address - Country:US
Practice Address - Phone:615-947-6390
Practice Address - Fax:615-550-7171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-28
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health