Healthcare Provider Details

I. General information

NPI: 1396237715
Provider Name (Legal Business Name): KINGS STAFFING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2018
Last Update Date: 06/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6416 N LAMBERT ST
PHILADELPHIA PA
19138-3020
US

IV. Provider business mailing address

1201 N 3RD ST STE 120
PHILADELPHIA PA
19122-4425
US

V. Phone/Fax

Practice location:
  • Phone: 267-714-2699
  • Fax:
Mailing address:
  • Phone: 267-714-2699
  • Fax: 267-543-6533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CARLOS A THOMPSON
Title or Position: CEO
Credential: BA
Phone: 215-390-7096