MEDICARE: PRESTIGE MEDICAL STAFFING LLC

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	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1861414997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESTIGE MEDICAL STAFFING LLC

Provider Business Mailing Address
First Line	:	65 HILL TOP DR
Second Line	:	P.O. BOX 24
City	:	RINDGE
State	:	NH
Zip	:	03461-5776
Country	:	US
Telephone Number	:	603-899-5757
Fax Number	:	603-899-2381

Provider Business Practice Location Address
First Line	:	65 HILL TOP DR
Second Line	:
City	:	RINDGE
State	:	NH
Zip	:	03461-5776
Country	:	US
Telephone Number	:	603-899-5757
Fax Number	:	603-899-2381

Authorized Official
Title or Position	:	MEMBER
Name	:	MRS. BARBARA A. JACOB
Credential	:	R.N.
Telephone Number	:	603-899-5757

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	08/22/2020

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