Organization
FIVE STAR MEDICAL SUPPLIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK M ANDERSON (PRESIDENT)
(563) 332-1334
Entity
Organization
Contact information
Practice address
1004 STATE ST, SUITE C, BETTENDORF, IA 52722-4856
(563) 332-1334
(563) 332-1359
Mailing address
1004 STATE ST, SUITE C, BETTENDORF, IA 52722-4856
(563) 332-1334
(563) 332-1359
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
182038180
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001596360
BLUE CROSS BLUE SHIELD
IL
05
—
0417774
—
IA
01
—
20064
BLUE CROSS BLUE SHIELD
IA
05
—
336664976001
—
IL
Enumeration date
12/04/2006
Last updated
04/02/2008
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