Provider Demographics
NPI:1851667620
Name:RX STAFFING & HOME CARE
Entity Type:Organization
Organization Name:RX STAFFING & HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:H
Authorized Official - Last Name:ERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:916-485-8200
Mailing Address - Street 1:4640 MARCONI AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-4355
Mailing Address - Country:US
Mailing Address - Phone:916-485-8200
Mailing Address - Fax:916-485-4400
Practice Address - Street 1:4640 MARCONI AVE STE 1
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-4355
Practice Address - Country:US
Practice Address - Phone:916-485-8200
Practice Address - Fax:916-485-4400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA314274253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA314274OtherGENERAL BUSINESS LICENSE