| Organization Name: | FIVE STAR INTERLOCAL COOPERATIVE |
| NPI Number: | 1366525255 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NANCY ANDERSON (EXECUTIVE DIRECTOR) |
| Mailing Address: | 1405 E Moses St Cushing |
| State: | OK US |
| Postal Code: | 740233635 |
| Phone Number: | 9182255600 |
| Fax Number: | 9182253026 |
| NPI Enumeration Date: | 10/23/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |