Healthcare Provider Details

I. General information

NPI: 1467437236
Provider Name (Legal Business Name): INTERSTAFF, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8522 OLIVE BLVD
SAINT LOUIS MO
63132-2800
US

IV. Provider business mailing address

9010 OVERLAND PLAZA
ST LOUIS MO
63114
US

V. Phone/Fax

Practice location:
  • Phone: 314-569-5830
  • Fax: 314-569-9026
Mailing address:
  • Phone: 314-569-5830
  • Fax: 314-569-9026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. SAMUELA KOYFMAN
Title or Position: PRESIDENT
Credential:
Phone: 314-569-5830