Provider Demographics
NPI:1487830410
Name:SPEEDYREEMPLOYMENT & MEDICARE SET-ASIDE
Entity Type:Organization
Organization Name:SPEEDYREEMPLOYMENT & MEDICARE SET-ASIDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCULLOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-824-0100
Mailing Address - Street 1:223 NE 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5530
Mailing Address - Country:US
Mailing Address - Phone:800-824-0100
Mailing Address - Fax:800-985-3391
Practice Address - Street 1:223 NE 5TH AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5530
Practice Address - Country:US
Practice Address - Phone:800-824-0100
Practice Address - Fax:800-985-3391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management