Provider Demographics
NPI:1447083407
Name:5 STAR LOGISTICS LLC
Entity type:Organization
Organization Name:5 STAR LOGISTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:IAFT
Authorized Official - Phone:919-272-0504
Mailing Address - Street 1:3428 SONG SPARROW DR
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-4800
Mailing Address - Country:US
Mailing Address - Phone:919-272-0504
Mailing Address - Fax:
Practice Address - Street 1:3428 SONG SPARROW DR
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-4800
Practice Address - Country:US
Practice Address - Phone:919-272-0504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care