Organization
STAR MEDICAL EQUIPMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA L TILLMAN (OWNER)
(563) 386-9220
Entity
Organization
Contact information
Practice address
1161 E KIMBERLY RD, STE. A, DAVENPORT, IA 52807-1769
(563) 386-9220
Mailing address
1161 E KIMBERLY RD, STE. A, DAVENPORT, IA 52807-1769
(563) 386-9220
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
IA
332B00000X
Durable Medical Equipment & Medical Supplies
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0098046
—
IA
05
—
0134783
—
IA
01
—
09804
WELLMARK BC BS
IA
Enumeration date
12/18/2006
Last updated
04/20/2008
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