Provider Demographics
NPI:1649501602
Name:FIVE STAR HEALTH SERVICES INC
Entity type:Organization
Organization Name:FIVE STAR HEALTH SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:PAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-252-7555
Mailing Address - Street 1:9379 SWANSON BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-6942
Mailing Address - Country:US
Mailing Address - Phone:515-252-7555
Mailing Address - Fax:515-252-8848
Practice Address - Street 1:9379 SWANSON BLVD STE E
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-6942
Practice Address - Country:US
Practice Address - Phone:515-252-7555
Practice Address - Fax:515-252-8848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-14
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IA11853336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2123417OtherPK