Provider Demographics
NPI:1225267016
Name:NIGHTINGALE STAFFING
Entity Type:Organization
Organization Name:NIGHTINGALE STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:C
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:912-355-6472
Mailing Address - Street 1:7B ALLEN-CAIL DRIVE
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458
Mailing Address - Country:US
Mailing Address - Phone:800-731-8003
Mailing Address - Fax:912-681-4165
Practice Address - Street 1:9100 WHITE BLUFF RD STE 301
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-4670
Practice Address - Country:US
Practice Address - Phone:912-355-6472
Practice Address - Fax:912-691-4716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA016R0006251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000407965HMedicaid
GA000407965NMedicaid