Provider Demographics
NPI:1609104132
Name:ABC NURSE REGISTRY, INC.
Entity Type:Organization
Organization Name:ABC NURSE REGISTRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:B
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:954-322-9400
Mailing Address - Street 1:5301 MCKINLEY ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-4636
Mailing Address - Country:US
Mailing Address - Phone:954-322-9400
Mailing Address - Fax:954-981-9261
Practice Address - Street 1:5301 MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-4636
Practice Address - Country:US
Practice Address - Phone:954-322-9400
Practice Address - Fax:954-981-9261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211102251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health