| Star City Medical Inc | |
|
3405 Brambleton Ave Roanoke VA 24018-6519 | |
| (540) 982-0250 | |
| (540) 381-2672 |
| Full Name | Star City Medical Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3405 Brambleton Ave, Roanoke, Virginia |
| Authorized Official Name and Position | Justin Lindsey (CEO) |
| Authorized Official Contact | 5409820250 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Star City Medical Inc 3405 Brambleton Ave Roanoke VA 24018-6519 Ph: (540) 982-0250 | Star City Medical Inc 3405 Brambleton Ave Roanoke VA 24018-6519 Ph: (540) 982-0250 |
| NPI Number | 1801592506 |
|---|---|
| Provider Enumeration Date | 02/03/2023 |
| Last Update Date | 02/03/2023 |
| Medicare PECOS PAC ID | 0143694943 |
|---|---|
| Medicare Enrollment ID | O20230317001496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801592506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Justin A Lindsey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871014423 PECOS PAC ID: 9830434190 Enrollment ID: I20181214002474 |
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