Organization
FIVE STAR MEDICAL SUPPLY INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN IJOMA EGEOLU III (PRESIDENT/CEO)
(210) 731-0500
Entity
Organization
Contact information
Practice address
1123 BABCOCK RD, STE. C, SAN ANTONIO, TX 78201-6917
(210) 731-0500
(210) 736-3740
Mailing address
1123 BABCOCK RD, STE. C, SAN ANTONIO, TX 78201-6917
(210) 731-0500
(210) 736-3740
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0088709
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183205701
—
TX
Enumeration date
06/04/2006
Last updated
07/02/2008
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