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General NPI Number Information
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NPI Number | 1376763896
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Entity Type | Organization
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Legal Business Name | STAFF CARE
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 10/17/2008
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Provider Practice Location Address
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Address Line | 100 MICHIGAN ST NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2560
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Country | US
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Telephone | 606-964-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 105F STONEBROOK PL # 417
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City | JACKSON
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State | TN
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Zip | 38305-3636
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Country | US
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Telephone | 773-640-6853
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Fax |
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Authorized Official
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Title or Position | STAFF CRNA
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Name | MS. YVETTE M. GEORGE
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Credential | CRNA
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Telephone | 773-640-6853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State | IL
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