Provider Demographics
NPI:1992938880
Name:ENCORE MEDICAL STAFFING
Entity type:Organization
Organization Name:ENCORE MEDICAL STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GROVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-781-5222
Mailing Address - Street 1:3 DUNWOODY PARK
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-7405
Mailing Address - Country:US
Mailing Address - Phone:678-781-5222
Mailing Address - Fax:678-781-5221
Practice Address - Street 1:3 DUNWOODY PARK
Practice Address - Street 2:SUITE 103
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-7405
Practice Address - Country:US
Practice Address - Phone:678-781-5222
Practice Address - Fax:678-781-5221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA081255251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care