Healthcare Provider Details

I. General information

NPI: 1730942343
Provider Name (Legal Business Name): BLESSINGS MEDICAL STAFFING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 TRADITIONS DR
LOGANVILLE GA
30052-2117
US

IV. Provider business mailing address

204 TRADITIONS DR
LOGANVILLE GA
30052-2117
US

V. Phone/Fax

Practice location:
  • Phone: 678-508-9551
  • Fax:
Mailing address:
  • Phone: 678-508-9551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: BLESSING CHIOMA BENJAMIN
Title or Position: OWNER
Credential: MBA
Phone: 678-508-9551