Provider Demographics
NPI:1659508976
Name:EXTRA PROFESSIONAL STAFFING, INC.
Entity Type:Organization
Organization Name:EXTRA PROFESSIONAL STAFFING, INC.
Other - Org Name:EXTRA POFESSIONAL NURSING REFERRAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:CHIMEZ
Authorized Official - Last Name:AMAECHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-616-9268
Mailing Address - Street 1:1055 TAYLOR AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-8317
Mailing Address - Country:US
Mailing Address - Phone:410-616-9268
Mailing Address - Fax:410-616-9289
Practice Address - Street 1:1055 TAYLOR AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-8317
Practice Address - Country:US
Practice Address - Phone:410-616-9268
Practice Address - Fax:410-616-9289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD090501251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care