NPIMap

Organization Active NPI

Star Medical Incorporated

  • Durable Medical Equipment & Medical Supplies
  • Rock Hill, SC
National Provider Identifier
1205032620
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
STAR MEDICAL INCORPORATED
Practice address
1023 Charlotte Ave
Rock Hill, SC 29732-3016
Phone
(803) 980-4343
Fax
(803) 980-1726
NPI assigned
Jun 22, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dorinda Q McClellan
Title
Co-Owner
Phone
(803) 980-4343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X SC Primary

Addresses

Primary practice location

1023 Charlotte Ave
Rock Hill, SC 29732-3016

Mailing address

1023 Charlotte Ave
Rock Hill, SC 29732-3016
Phone (803) 980-4343

Other identifiers 1

IdentifierTypeStateIssuer
DE2803MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Star Medical Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205032620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 CHARLOTTE AVE",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323016",
            "telephone_number": "803-980-4343",
            "fax_number": "803-980-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 CHARLOTTE AVE",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323016",
            "telephone_number": "803-980-4343",
            "fax_number": "803-980-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR MEDICAL INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCLELLAN",
        "authorized_official_first_name": "DORINDA",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "803-980-4343"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE2803",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.