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Organization
STAR FORMULA INC
Active
Organization
STAR FORMULA INC
Active
Other names
Star Medical Specialties
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER J MITCHELL (OWNER)
(972) 380-2065
Entity
Organization
Contact information
Practice address
4386 SUNBELT DR, ADDISON, TX 75001-5611
(972) 380-2065
(972) 380-0948
Mailing address
4386 SUNBELT DR, ADDISON, TX 75001-5611
(972) 380-2065
(972) 380-0948
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
1001387
TX
Other
Enumeration date
07/08/2016
Last updated
01/20/2021
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