=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629885876
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CRITCHFIELD STAFFING SOLUTIONS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/11/2024
-----------------------------------------------------
Last Update Date | 12/11/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 742 S MAIN ST
-----------------------------------------------------
City | GREENSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15601-4137
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-396-8979
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 742 S MAIN ST
-----------------------------------------------------
City | GREENSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15601-4137
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-396-8979
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT AND CEO
-----------------------------------------------------
Name | MR. SCOTT G CRITCHFIELD II
-----------------------------------------------------
Credential | MBA
-----------------------------------------------------
Telephone | 724-396-8979
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QI0500X
-----------------------------------------------------
Taxonomy Name | Infusion Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------