Provider Demographics
NPI:1194548495
Name:PRN STAFFERS ATL
Entity type:Organization
Organization Name:PRN STAFFERS ATL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EARNESTINE
Authorized Official - Middle Name:OLIVER
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-317-6184
Mailing Address - Street 1:3029 BROOK LN
Mailing Address - Street 2:
Mailing Address - City:REX
Mailing Address - State:GA
Mailing Address - Zip Code:30273-2434
Mailing Address - Country:US
Mailing Address - Phone:302-317-6184
Mailing Address - Fax:302-829-3109
Practice Address - Street 1:3029 BROOK LN
Practice Address - Street 2:
Practice Address - City:REX
Practice Address - State:GA
Practice Address - Zip Code:30273-2434
Practice Address - Country:US
Practice Address - Phone:302-317-6184
Practice Address - Fax:302-829-3109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care