MEDICARE: ALFRED'S MEDICAL STAFFING AGENCY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1770994048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALFRED'S MEDICAL STAFFING AGENCY

Provider Business Mailing Address
First Line	:	107 SAINT HILARY DR
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70507-4702
Country	:	US
Telephone Number	:	337-303-3227
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 TRAVIS ST
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-2461
Country	:	US
Telephone Number	:	337-534-8968
Fax Number	:	337-534-8938

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. STEPHANIE ALFRED
Credential	:
Telephone Number	:	337-303-3227

Provider Enumeration Date	:	05/08/2014
Last Update Date	:	05/08/2014

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