Provider Demographics
NPI:1699206433
Name:FIVE STAR EXPORT, INC
Entity type:Organization
Organization Name:FIVE STAR EXPORT, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:NNABUIFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-509-6431
Mailing Address - Street 1:10212 AUTUMN CIR
Mailing Address - Street 2:
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-4317
Mailing Address - Country:US
Mailing Address - Phone:216-509-6431
Mailing Address - Fax:
Practice Address - Street 1:10212 AUTUMN CIR
Practice Address - Street 2:
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241-4317
Practice Address - Country:US
Practice Address - Phone:216-509-6431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health