Provider Demographics
NPI:1912705567
Name:DISTANCE MEDICAL STAFFING LLC
Entity type:Organization
Organization Name:DISTANCE MEDICAL STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEGGIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-300-4200
Mailing Address - Street 1:1806 CHANTILLY ST STE 1
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3513
Mailing Address - Country:US
Mailing Address - Phone:571-300-4200
Mailing Address - Fax:
Practice Address - Street 1:1806 CHANTILLY ST STE 1
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3513
Practice Address - Country:US
Practice Address - Phone:571-300-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based