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General NPI Number Information
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NPI Number | 1881830560
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Entity Type | Organization
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Legal Business Name | ALPHA ONE STAFFING, LLC
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Dates
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Enumeration Date | 12/30/2008
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Last Update Date | 12/30/2008
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Provider Practice Location Address
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Address Line | 416 S MAIN ST SUITE- G
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City | MAULDIN
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State | SC
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Zip | 29662-2260
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Country | US
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Telephone | 864-399-9627
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Fax |
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Provider Business Mailing Address
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Address Line | 416 SOUTH MAIN ST. SUITE-G
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City | MALUDIN
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State | SC
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Zip | 29662
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Country | US
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Telephone | 864-399-9627
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF ADM./ OWNER
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Name | MR. ROY GARY
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Credential |
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Telephone | 864-399-9627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | EX0850
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License Number State | SC
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