Organization
STARLIGHT HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL ZINKENG ASONGANYI (CHIEF EXECUTIVE OFFICER)
(240) 782-0094
Entity
Organization
Contact information
Practice address
12656 HEMING LN, BOWIE, MD 20716-1119
(240) 782-0094
Mailing address
12656 HEMING LANE, BOWIE, MD 20716
(240) 782-0094
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001565399
WORK ORDER NUMBER
MD
01
—
0002122361
COSTUMER ID
MD
01
—
1000361996307827
FILLING NUMBER
MD
01
—
W12497004
DEPARTMENT ID
MD
Enumeration date
06/16/2008
Last updated
06/16/2008
Update your record
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