| Organization Name: | BEACHSTAR HEALTHCARE LLC |
| NPI Number: | 1649557174 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ASHLEY S. PARK (PRESIDENT/OWNER) |
| Mailing Address: | 1022 Grandiflora Dr Suite 240 Leland |
| State: | NC US |
| Postal Code: | 284517007 |
| Phone Number: | 9105999555 |
| Fax Number: | 9105999557 |
| NPI Enumeration Date: | 11/11/2011 |
| NPI Last Update Date: | 11/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | HC4476 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |