Provider Demographics
NPI:1801592506
Name:STAR CITY MEDICAL INC
Entity type:Organization
Organization Name:STAR CITY MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:540-982-0250
Mailing Address - Street 1:1606 APPERSON DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-7217
Mailing Address - Country:US
Mailing Address - Phone:540-375-2686
Mailing Address - Fax:540-381-2672
Practice Address - Street 1:1606 APPERSON DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7217
Practice Address - Country:US
Practice Address - Phone:540-375-2686
Practice Address - Fax:540-381-2672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-03
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center