Provider Demographics
NPI:1972379147
Name:PRN STAFFERS DAL
Entity type:Organization
Organization Name:PRN STAFFERS DAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
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 1:2149 DENTON RD STE 2
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-2374
Mailing Address - Country:US
Mailing Address - Phone:302-751-3274
Mailing Address - Fax:
Practice Address - Street 1:2149 DENTON RD STE 2
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-2374
Practice Address - Country:US
Practice Address - Phone:302-751-3274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRN STAFFERS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health