STAR FORMULA INC (NPI# 1720554108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720554108 |
| Entity Type | Organization |
| Organization Name | STAR FORMULA INC |
| Practice Address |
1477 Lomaland Dr Ste B1 El Paso TX 79935-4704 |
| Mailing Address |
4386 Sunbelt Dr Addison TX 75001-5611 |
| Practice Telephone | 9152136995 |
| Practice Fax Number | 9155645548 |
| Mailing Telephone | 8003682065 |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2018-10-23 |
| Authorized Official Name | GREG L JACKSON (CEO) |
| Authorized Official Telephone | 8003682065 |
| Authorized Official Credential | AO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers |
| Other Name | Type Code |
|---|---|
| Star Medical Specialties | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669949046 | Star Formula Inc | Durable Medical Equipment & Medical Supplies | 428 E Jefferson Blvd Ste 123, Dallas, TX 75203-5613 | 2018-10-24 |
| 1841766235 | Star Formula Inc | Durable Medical Equipment & Medical Supplies | 421 W Magnolia Ave, Fort Worth, TX 76104-7618 | 2018-10-23 |
| 1538511910 | Star Formula Inc | Durable Medical Equipment & Medical Supplies | 4386 Sunbelt Dr, Addison, TX 75001-5611 | 2016-07-08 |
| Street Address |
1477 LOMALAND DR STE B1 |
| City | EL PASO |
| State | TX |
| Zip Code | 79935-4704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093261604 | Julio Alcala | Radiologic Technologist | 10291 Pellicano Suite 102, El Paso, TX 79935 | 2016-09-01 |
| 1760841423 | Anant Shukla | Preventive Medicine | Mendoza Aviation Clinic (11335 Ssg Sims Blvd), El Paso, TX 79935 | 2016-02-23 |
| 1306249834 | Ector County Hospital District | Skilled Nursing Facility | 1599 Lomaland Drive, El Paso, TX 79935 | 2014-09-29 |
| 1164831079 | Elizabeth Espinoza | Pharmacist | 2112 Trawood, El Paso, TX 79935 | 2014-08-05 |
| 1396151759 | The Lasik Vision Institute LLC | Clinic/Center | 10961 Gateway, Suite 300, El Paso, TX 79935 | 2014-07-07 |
| 1427461896 | Henry Vu | Optometrist | 10961 Gateway West, Ste 300, El Paso, TX 79935 | 2014-06-03 |
| 1982947636 | Novoa Medical Services, Pa | Obstetrics & Gynecology | 10781 Pebble Hills, Suite A, El Paso, TX 79935 | 2013-04-01 |
| 1366796724 | New Leaf Wellness Center | Counselor | 10921 Pellicano Dr Ste 110, El Paso, TX 79935 | 2012-11-06 |
| 1295980670 | Amy Latonia Hensley | Massage Therapist | 2278 Trawood Dr., Ste. C, El Paso, TX 79935 | 2008-11-26 |
| 1477752855 | Sunland Optical Co Inc | Durable Medical Equipment & Medical Supplies | 1156 Barranca, El Paso, TX 79935 | 2007-07-16 |
| Find all providers in zip 79935 | ||||
| Taxonomy Code | 332BP3500X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Parenteral & Enteral Nutrition |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326356387 | Ulisses Acuna | Durable Medical Equipment & Medical Supplies | 1530 Goodyear Dr Ste A1, El Paso, TX 79936-6037 | 2010-09-23 |
| 1356652275 | Segruf, L.L.C. | Durable Medical Equipment & Medical Supplies | 3465 Lee Blvd Ste 233, El Paso, TX 79936-1475 | 2010-06-25 |
| 1205082658 | Pl Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 8899 Alameda Ave Ste 117, El Paso, TX 79907-6288 | 2008-08-15 |
| 1134286271 | Medcast, Inc | Durable Medical Equipment & Medical Supplies | 7501 Lockheed Dr, Suite B, El Paso, TX 79925-2458 | 2007-01-01 |
| 1689684128 | Apria Healthcare LLC | Durable Medical Equipment & Medical Supplies | 11500 Pellicano Dr, Ste C1, El Paso, TX 79936-6052 | 2006-08-08 |
| 1770541435 | West Texas Provider Services LLC | Durable Medical Equipment & Medical Supplies | 200 Bartlett Dr, Suite 108, El Paso, TX 79912-1628 | 2006-05-03 |
| 1679531651 | Multi-medical Services Inc | Durable Medical Equipment & Medical Supplies | 11551 Chito Samaniego Dr, El Paso, TX 79936-7424 | 2006-05-01 |
| 1881685162 | The Evangelical Lutheran Good Samaritan Society | Durable Medical Equipment & Medical Supplies | 7304 Good Samaritan Ct, El Paso, TX 79912-1602 | 2005-11-04 |
| 1477547552 | Advant Edge Pharmacy, Inc | Durable Medical Equipment & Medical Supplies | 1576 Lomaland Dr, El Paso, TX 79935-4202 | 2005-09-06 |
| 1174529945 | Victor Gomez Vanval Enterprise | Durable Medical Equipment & Medical Supplies | 11601 Pellicano Dr, Suite B8, El Paso, TX 79936-6279 | 2005-06-24 |
| Find all providers in EL PASO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.