Provider Demographics
NPI:1093944803
Name:MAS MEDICAL STAFFING CORPORATION
Entity Type:Organization
Organization Name:MAS MEDICAL STAFFING CORPORATION
Other - Org Name:MAS HOME CARE OF NEW HAMPSHIRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-232-0972
Mailing Address - Street 1:156 HARVEY RD
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-7449
Mailing Address - Country:US
Mailing Address - Phone:603-232-0972
Mailing Address - Fax:
Practice Address - Street 1:156 HARVEY RD
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-7449
Practice Address - Country:US
Practice Address - Phone:603-232-0972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03490251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health