1902062177 NPI number — WISE MEDICAL STAFFING, INC.

Table of content: (NPI 1902062177)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902062177 NPI number — WISE MEDICAL STAFFING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WISE MEDICAL STAFFING, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902062177
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6 HEATH DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHILLICOTHEE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45601-2523
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-775-4108
Provider Business Mailing Address Fax Number:
740-775-3733

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6 HEATH DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHILLICOTHEE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45601-2523
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-775-4108
Provider Business Practice Location Address Fax Number:
740-775-3733
Provider Enumeration Date:
08/06/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HAMILTON
Authorized Official First Name:
SHIRLEY
Authorized Official Middle Name:
K
Authorized Official Title or Position:
RN ADMINISTRATOR
Authorized Official Telephone Number:
740-775-4108

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 253Z00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 372500000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 372600000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747A0650X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747P1801X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 376J00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 376K00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)