Five Star Medical Supply Incorporated

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0088709 Issued in TX

Legal business name

FIVE STAR MEDICAL SUPPLY INCORPORATED

Practice address

1123 Babcock Rd
Ste. C
San Antonio, TX 78201-6917

Phone

(210) 731-0500

Fax

(210) 736-3740

NPI assigned

Jun 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John Ijoma Egeolu III

Title

President/Ceo

Phone

(210) 731-0500

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1548208036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 BABCOCK RD",
            "address_2": "STE. C",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782016917",
            "telephone_number": "210-731-0500",
            "fax_number": "210-736-3740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 BABCOCK RD",
            "address_2": "STE. C",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782016917",
            "telephone_number": "210-731-0500",
            "fax_number": "210-736-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR MEDICAL SUPPLY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "EGEOLU",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "IJOMA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "210-731-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0088709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183205701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Five Star Rehabilitation and Wellness Services, LLC. (Ageility Physical Therapy Solutions at San Antonio)
• Kassidy Fix, DO
• FJR Nutrition

• Durable Medical Equipment & Medical Supplies in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.