Healthcare Provider Details

I. General information

NPI: 1699801571
Provider Name (Legal Business Name): BALANCE MEDICAL STAFFING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 RANDOLPH RD SUITE 205
CHARLOTTE NC
28211-2351
US

IV. Provider business mailing address

4425 RANDOLPH RD SUITE 205
CHARLOTTE NC
28211-2351
US

V. Phone/Fax

Practice location:
  • Phone: 704-364-7886
  • Fax: 704-780-1111
Mailing address:
  • Phone: 704-364-7886
  • Fax: 704-780-1111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNC

VIII. Authorized Official

Name: MR. MICHAEL JASON CORVAIA
Title or Position: V.P. OF OPERATIONS AND SALES
Credential:
Phone: 704-364-7886