Provider Demographics
NPI:1043770530
Name:COMBINED NURSING SERVICES LLC
Entity Type:Organization
Organization Name:COMBINED NURSING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUPHAMAS
Authorized Official - Middle Name:YATENG
Authorized Official - Last Name:VANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-207-6510
Mailing Address - Street 1:1039 ROBERT ST S
Mailing Address - Street 2:
Mailing Address - City:WEST SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-1455
Mailing Address - Country:US
Mailing Address - Phone:651-207-6510
Mailing Address - Fax:651-493-7908
Practice Address - Street 1:1039 ROBERT ST S
Practice Address - Street 2:
Practice Address - City:WEST SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-1455
Practice Address - Country:US
Practice Address - Phone:651-207-6510
Practice Address - Fax:651-493-7908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health