Provider Demographics
NPI:1649967589
Name:TDM MEDICAL STAFFING AGENCY PLLC
Entity type:Organization
Organization Name:TDM MEDICAL STAFFING AGENCY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRISCHELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-521-8325
Mailing Address - Street 1:2228 S 238TH LN
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-3609
Mailing Address - Country:US
Mailing Address - Phone:623-521-8325
Mailing Address - Fax:623-000-0000
Practice Address - Street 1:2406 S 24TH STREET
Practice Address - Street 2:STE 216
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034
Practice Address - Country:US
Practice Address - Phone:623-521-8325
Practice Address - Fax:623-000-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-20
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health