Provider Demographics
NPI:1043540479
Name:OCEAN STAR HEALTHCARE SERVICES,LLC
Entity type:Organization
Organization Name:OCEAN STAR HEALTHCARE SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER/D. MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:EKWUTOSI
Authorized Official - Last Name:ANUNOBY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, FNP-BC, RN
Authorized Official - Phone:573-418-3688
Mailing Address - Street 1:735 DEAN DR
Mailing Address - Street 2:P.O. BOX 1416
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-0501
Mailing Address - Country:US
Mailing Address - Phone:573-418-3688
Mailing Address - Fax:573-632-4326
Practice Address - Street 1:735 DEAN DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-0501
Practice Address - Country:US
Practice Address - Phone:573-418-3688
Practice Address - Fax:573-632-4326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care