1538495452 NPI number — MAS MEDICAL STAFFING CORPORATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538495452 NPI number — MAS MEDICAL STAFFING CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAS MEDICAL STAFFING CORPORATION
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:
6
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:
1538495452
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 HARVEY RD
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
MANCHESTER
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03103-3336
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-296-0953
Provider Business Mailing Address Fax Number:
603-215-2110

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21 SACO ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTBROOK
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04092-2856
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-591-4157
Provider Business Practice Location Address Fax Number:
207-591-4159
Provider Enumeration Date:
10/28/2009

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
KENNETH
Authorized Official Middle Name:
C
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
603-296-0953

Provider Taxonomy Codes

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

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





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