Healthcare Provider Details

I. General information

NPI: 1245467760
Provider Name (Legal Business Name): LAXUR MEDICAL STAFFING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2009
Last Update Date: 10/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 LONG BEACH BLVD SUITE 214
LONG BEACH CA
90807-3315
US

IV. Provider business mailing address

PO BOX 7773
LONG BEACH CA
90807-0773
US

V. Phone/Fax

Practice location:
  • Phone: 800-977-1006
  • Fax:
Mailing address:
  • Phone: 800-977-1006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARTHA GEBREMICHAEL
Title or Position: MANAGER
Credential:
Phone: 800-977-1006