Provider Demographics
NPI:1336246768
Name:ALL STAR HOME RESPIRATORY
Entity Type:Organization
Organization Name:ALL STAR HOME RESPIRATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-328-1296
Mailing Address - Street 1:1954 DOLGNER PL
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-9225
Mailing Address - Country:US
Mailing Address - Phone:407-328-1296
Mailing Address - Fax:407-947-4370
Practice Address - Street 1:1954 DOLGNER PL
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-9225
Practice Address - Country:US
Practice Address - Phone:407-328-1296
Practice Address - Fax:407-947-4370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312137332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1312137OtherHOME MEDICAL LICENSE
FL5114380001Medicare NSC