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General NPI Number Information
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NPI Number | 1326322959
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Entity Type | Organization
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Legal Business Name | SOUTHERN MEDICAL STAFFING, LLC
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Dates
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Enumeration Date | 09/30/2011
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Last Update Date | 09/30/2011
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Provider Practice Location Address
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Address Line | 1305 METRO DR SUITE 6
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3444
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Country | US
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Telephone | 318-445-2035
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Fax | 318-445-2330
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Provider Business Mailing Address
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Address Line | 1305 METRO DR SUITE 6
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3444
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Country | US
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Telephone | 318-445-2035
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Fax | 318-445-2330
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Authorized Official
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Title or Position | OWNER
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Name | MRS. AMY R MCNULTY
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Credential | RN
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Telephone | 318-445-2035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 5852826
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License Number State | LA
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