Basic Information
| Provider Information | |||||||||
| NPI: | 1588996722 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDICAL STAFFING NETWORK, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 901 YAMATO RD STE 110 | ||||||||
| Address2: | |||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334314415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613221300 | ||||||||
| FaxNumber: | 5613221200 | ||||||||
| Practice Location | |||||||||
| Address1: | 1901 MEDI PARK DR STE 39 | ||||||||
| Address2: | |||||||||
| City: | AMARILLO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 791062105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8063532101 | ||||||||
| FaxNumber: | 8063532674 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2010 | ||||||||
| LastUpdateDate: | 02/12/2010 | ||||||||
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| AuthorizedOfficialLastName: | LITTLE | ||||||||
| AuthorizedOfficialFirstName: | KEVIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5613221300 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | MEDICAL STAFFING NETWORK, INC. | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | 008375 | TX | Y | Agencies | Home Health |
No ID Information.