1033345616 NPI number — NIGHTINGALE STAFFING, INC.

Table of content: (NPI 1033345616)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033345616 NPI number — NIGHTINGALE STAFFING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NIGHTINGALE 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:
1033345616
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/31/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
606 W COURT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WRIGHTSVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31096-1200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
478-864-6055
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9100 WHITE BLUFF RD STE 301
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAVANNAH
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31406-4670
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-920-5161
Provider Business Practice Location Address Fax Number:
912-691-4716
Provider Enumeration Date:
06/09/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SIMS
Authorized Official First Name:
HAROLD
Authorized Official Middle Name:
C
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
912-355-6472

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  150R0004 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000407965M , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000407965G , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".