Star Medical Supply, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

STAR MEDICAL SUPPLY, INC

Practice address

6802 Ringgold Rd Ste 105
East Ridge, TN 37412-4256

Phone

(423) 771-7808

NPI assigned

Jan 19, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Raquel Celine Benavidez

Title

Owner

Phone

(423) 771-7808

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516320000000",
    "number": "1053829481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6802 RINGGOLD RD STE 105",
            "city": "EAST RIDGE",
            "state": "TN",
            "postal_code": "374124256",
            "telephone_number": "423-771-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6802 RINGGOLD RD STE 105",
            "city": "EAST RIDGE",
            "state": "TN",
            "postal_code": "374124256",
            "telephone_number": "423-771-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR MEDICAL SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-19",
        "last_updated": "2018-01-19",
        "status": "A",
        "authorized_official_last_name": "BENAVIDEZ",
        "authorized_official_first_name": "RAQUEL",
        "authorized_official_middle_name": "CELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-771-7808"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in East Ridge, TN
• Providers in East Ridge, TN by specialty
• Durable Medical Equipment & Medical Supplies in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.