Organization
STAR SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL AVEINA LANGKILDE (PRESIDENT)
(684) 258-8050
Entity
Organization
Contact information
Practice address
3505 TAFUNA RD, PAGO PAGO, AS 96799
(684) 258-8050
Mailing address
PO BOX 3505, PAGO PAGO, AS 96799-3505
(684) 254-1437
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BD1200X
Dialysis Equipment & Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
12/07/2017
Last updated
12/07/2017
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