Provider Demographics
NPI:1629213863
Name:JOB1USA STAFFING
Entity type:Organization
Organization Name:JOB1USA STAFFING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF MEDICAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:419-259-5611
Mailing Address - Street 1:701 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-6955
Mailing Address - Country:US
Mailing Address - Phone:419-259-5611
Mailing Address - Fax:419-724-2822
Practice Address - Street 1:701 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-6955
Practice Address - Country:US
Practice Address - Phone:419-259-5611
Practice Address - Fax:419-724-2822
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RUMPF CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0770581Medicaid