Provider Demographics
NPI:1083372668
Name:SOLOMON MEDICAL STAFFING AGENCY LLC
Entity Type:Organization
Organization Name:SOLOMON MEDICAL STAFFING AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-935-2689
Mailing Address - Street 1:6416 W CAPITOL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2153
Mailing Address - Country:US
Mailing Address - Phone:414-935-2689
Mailing Address - Fax:414-935-2101
Practice Address - Street 1:6416 W CAPITOL DR STE 200
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2153
Practice Address - Country:US
Practice Address - Phone:414-935-2689
Practice Address - Fax:414-935-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health