1831235365 NPI number — MID ATLANTIC HEALTH STAFFING, INC.

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 1831235365 NPI number — MID ATLANTIC HEALTH STAFFING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MID ATLANTIC HEALTH 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:
1831235365
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
925 SIDEHILL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEL AIR
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21015-6348
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-527-1896
Provider Business Mailing Address Fax Number:
443-836-0099

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
925 SIDEHILL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEL AIR
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21015-6348
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-527-1896
Provider Business Practice Location Address Fax Number:
443-836-0099
Provider Enumeration Date:
01/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VILLAREAL
Authorized Official First Name:
ERIC
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
443-506-8898

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X , with the licence number:  0504009 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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