Provider Demographics
NPI:1184728446
Name:HEALTHSTAR HOMECARE SERVICES LLC
Entity type:Organization
Organization Name:HEALTHSTAR HOMECARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT HEALTHSTAR HOMECARE
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:VANSCIVER
Authorized Official - Suffix:
Authorized Official - Credentials:RESPIRATORY THERAPIS
Authorized Official - Phone:720-851-7028
Mailing Address - Street 1:10234 PROGRESS LN
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-4044
Mailing Address - Country:US
Mailing Address - Phone:720-851-7028
Mailing Address - Fax:720-528-8105
Practice Address - Street 1:10234 PROGRESS LN
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-4044
Practice Address - Country:US
Practice Address - Phone:303-991-5883
Practice Address - Fax:720-528-8105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42168910000332BC3200X
CO4203332BC3200X
CO1165332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO882060000OtherBCBS
CO86959816Medicaid
CO1407312OtherCIGNA
CO1407312OtherCIGNA