# FIVE STAR MEDICAL SUPPLY INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548208036
- **Authorized official:** DR. JOHN IJOMA EGEOLU III (PRESIDENT/CEO)
- **Authorized official phone:** (210) 731-0500

## Contact information

- **Practice address:** 1123 BABCOCK RD, STE. C, SAN ANTONIO, TX 78201-6917
- **Practice address phone:** (210) 731-0500
- **Practice address fax:** (210) 736-3740
- **Mailing address:** 1123 BABCOCK RD, STE. C, SAN ANTONIO, TX 78201-6917
- **Mailing address phone:** (210) 731-0500
- **Mailing address fax:** (210) 736-3740

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0088709 | TX | Yes |

## Other

- **Enumeration date:** 06/04/2006
- **Last updated:** 07/02/2008