Provider Demographics
NPI:1336306620
Name:INSITE HOLDINGS LLC
Entity Type:Organization
Organization Name:INSITE HOLDINGS LLC
Other - Org Name:5 STAR MEDICAL SUPPLY COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TARQUEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-683-3005
Mailing Address - Street 1:621 RED MAPLE PL
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-1288
Mailing Address - Country:US
Mailing Address - Phone:678-683-3005
Mailing Address - Fax:
Practice Address - Street 1:2000 POWERS FERRY RD
Practice Address - Street 2:SUITE 2-10
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-9476
Practice Address - Country:US
Practice Address - Phone:678-952-6207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA123456332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies