MEDICARE: MEDICAL STAFFING NETWORK HEALTHCARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1083920243
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL STAFFING NETWORK HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	901 YAMATO RD STE 110
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33431-4415
Country	:	US
Telephone Number	:	561-322-1300
Fax Number	:	561-322-1400

Provider Business Practice Location Address
First Line	:	2198 E CAMELBACK RD STE 360
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4716
Country	:	US
Telephone Number	:	602-279-5600
Fax Number	:	602-955-1752

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. KEVIN LITTLE
Credential	:
Telephone Number	:	561-322-1300

Provider Enumeration Date	:	08/26/2010
Last Update Date	:	08/26/2010

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