Healthcare Provider Details

I. General information

NPI: 1356321723
Provider Name (Legal Business Name): PROFESSIONAL MEDICAL STAFFING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 HILLTOP LN
STANFORD KY
40484-8414
US

IV. Provider business mailing address

PO BOX 87
MC KINNEY KY
40448-0087
US

V. Phone/Fax

Practice location:
  • Phone: 606-365-7402
  • Fax: 606-365-9282
Mailing address:
  • Phone: 606-365-7402
  • Fax: 606-365-9282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT W TODD
Title or Position: CEO/OWNER
Credential:
Phone: 606-365-7402