1760527659 NPI number — STARS INVESTMENT INC

Table of content: (NPI 1760527659)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760527659 NPI number — STARS INVESTMENT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STARS INVESTMENT INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760527659
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/29/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4020 VENOY RD
Provider Second Line Business Mailing Address:
STE 200A
Provider Business Mailing Address City Name:
WAYNE
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48184-1869
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-729-2882
Provider Business Mailing Address Fax Number:
734-729-4586

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4020 VENOY RD
Provider Second Line Business Practice Location Address:
STE 200A
Provider Business Practice Location Address City Name:
WAYNE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48184-1869
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-729-2882
Provider Business Practice Location Address Fax Number:
734-729-4586
Provider Enumeration Date:
02/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ISMAIL
Authorized Official First Name:
HASSAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACIST/OWNER
Authorized Official Telephone Number:
734-729-2882

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , with the licence number:  5301006869 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2358857 . This is a "NABP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com