Provider Demographics
NPI:1821329590
Name:CLASSIC MEDICAL STAFFING,LLC
Entity Type:Organization
Organization Name:CLASSIC MEDICAL STAFFING,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:MCANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-799-4500
Mailing Address - Street 1:20800 WESTGATE MALL
Mailing Address - Street 2:WESTGATE PROFESSIONAL CENTER, SUITE 100
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-1323
Mailing Address - Country:US
Mailing Address - Phone:440-799-4500
Mailing Address - Fax:440-799-4502
Practice Address - Street 1:20800 WESTGATE MALL
Practice Address - Street 2:WESTGATE PROFESSIONAL CENTER, SUITE 100
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-1323
Practice Address - Country:US
Practice Address - Phone:440-799-4500
Practice Address - Fax:440-799-4502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care