Provider Demographics
NPI:1679752885
Name:FIVE STAR SURGICAL SUPPLY INC.
Entity type:Organization
Organization Name:FIVE STAR SURGICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CUI MEI
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-686-6656
Mailing Address - Street 1:5124 9TH AVE
Mailing Address - Street 2:ROOM S3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2923
Mailing Address - Country:US
Mailing Address - Phone:718-686-6656
Mailing Address - Fax:718-686-6658
Practice Address - Street 1:5124 9TH AVE
Practice Address - Street 2:# S3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2923
Practice Address - Country:US
Practice Address - Phone:718-686-6656
Practice Address - Fax:718-686-6658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies