Healthcare Provider Details

I. General information

NPI: 1720401417
Provider Name (Legal Business Name): MAS MEDICAL STAFFING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2014
Last Update Date: 01/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 PLANTATION ST
WORCESTER MA
01604-1637
US

IV. Provider business mailing address

156 HARVEY RD
LONDONDERRY NH
03053-7449
US

V. Phone/Fax

Practice location:
  • Phone: 508-459-2424
  • Fax:
Mailing address:
  • Phone: 603-232-0972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. KEN C JOHNSON
Title or Position: OWNER
Credential:
Phone: 603-232-0972