Provider Demographics
NPI:1356593735
Name:ASSURANT MEDICAL STAFFING & HEALTHCARE SERVICES
Entity type:Organization
Organization Name:ASSURANT MEDICAL STAFFING & HEALTHCARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:TINDAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-665-1691
Mailing Address - Street 1:549 W EVANS ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-3407
Mailing Address - Country:US
Mailing Address - Phone:843-665-1691
Mailing Address - Fax:843-665-1692
Practice Address - Street 1:1920 KENSINGTON ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-3256
Practice Address - Country:US
Practice Address - Phone:843-319-6686
Practice Address - Fax:843-679-2005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251300000XAgenciesLocal Education Agency (LEA)
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305S00000XManaged Care OrganizationsPoint of Service
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1356593735Medicaid
SC1356593735Medicare PIN
SC1356593735Medicare UPIN
SC1356593735Medicare Oscar/Certification
SC1356593735Medicare NSC