Provider Demographics
NPI:1477704823
Name:ADVANCED MEDICAL STAFFING LLC
Entity Type:Organization
Organization Name:ADVANCED MEDICAL STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SERGENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-371-1344
Mailing Address - Street 1:12608 LAKE RIDGE DR STE A
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2389
Mailing Address - Country:US
Mailing Address - Phone:703-499-9099
Mailing Address - Fax:703-499-9077
Practice Address - Street 1:12608 LAKE RIDGE DR STE A
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2389
Practice Address - Country:US
Practice Address - Phone:703-499-9099
Practice Address - Fax:703-499-9077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-09518251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health