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General NPI Number Information
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NPI Number | 1770124349
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Entity Type | Organization
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Legal Business Name | WAYMAKER MEDSTAFF LLC
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Dates
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Enumeration Date | 10/03/2019
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 5458 FULTON RD, CANTON OHIO 44718 SUITE B
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City | CANTON
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State | OH
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Zip | 44718-5329
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Country | US
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Telephone | 330-465-4987
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 765
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City | GREEN
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State | OH
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Zip | 44232-0765
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Country | US
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Telephone | 330-212-5554
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LEBERLIZA STALCUP
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Credential |
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Telephone | 330-212-5554
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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 |
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License Number State |
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