Provider Demographics
NPI:1588138184
Name:STARZOM, LLC
Entity type:Organization
Organization Name:STARZOM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SINGLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LUL
Authorized Official - Middle Name:NOOR
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-483-2319
Mailing Address - Street 1:803 SOUTH PLYMOUTH AVENUE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14608
Mailing Address - Country:US
Mailing Address - Phone:585-287-6982
Mailing Address - Fax:585-471-8016
Practice Address - Street 1:803 SOUTH PLYMOUTH AVENUE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14608
Practice Address - Country:US
Practice Address - Phone:585-483-2319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker