Provider Demographics
NPI:1538495452
Name:MAS MEDICAL STAFFING CORPORATION
Entity Type:Organization
Organization Name:MAS MEDICAL STAFFING CORPORATION
Other - Org Name:MAS HOME CARE OF MAINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-296-0953
Mailing Address - Street 1:500 HARVEY RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3336
Mailing Address - Country:US
Mailing Address - Phone:603-296-0953
Mailing Address - Fax:603-215-2110
Practice Address - Street 1:21 SACO ST
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-2856
Practice Address - Country:US
Practice Address - Phone:207-591-4157
Practice Address - Fax:207-591-4159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health