Provider Demographics
NPI:1912200742
Name:CUMBERLAND MEDICAL STAFFING
Entity Type:Organization
Organization Name:CUMBERLAND MEDICAL STAFFING
Other - Org Name:CUMBERLAND MEDICAL STAFFING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JONAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ODEKHIRAN
Authorized Official - Suffix:
Authorized Official - Credentials:NRC
Authorized Official - Phone:770-435-2555
Mailing Address - Street 1:3411 AUSTELL RD SW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30008-5796
Mailing Address - Country:US
Mailing Address - Phone:770-435-2555
Mailing Address - Fax:678-324-1044
Practice Address - Street 1:3411 AUSTELL RD SW
Practice Address - Street 2:SUITE 100
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30008-5796
Practice Address - Country:US
Practice Address - Phone:770-435-2555
Practice Address - Fax:678-324-1044
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CUMBERLAND HEALTH SERVICES & TRAINING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility