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General NPI Number Information
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NPI Number | 1730364381
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Entity Type | Organization
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Legal Business Name | SHORE STAFFING, INC.
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 12339 SHERBORNE ST
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City | BRISTOW
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State | VA
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Zip | 20136-2003
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Country | US
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Telephone | 703-393-8806
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Fax |
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Provider Business Mailing Address
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Address Line | 3109 FAIR ISLAND LN
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City | MARION STATION
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State | MD
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Zip | 21838-2461
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Country | US
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Telephone | 410-957-2800
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. BONNIE P BURKE
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Credential |
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Telephone | 410-957-2800
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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 | SA-02084
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License Number State | MD
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