Provider Demographics
NPI:1811268261
Name:RW NURSING STAFFING AGENCY
Entity type:Organization
Organization Name:RW NURSING STAFFING AGENCY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TARMERA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:WYCKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELOR OF SCIENCE
Authorized Official - Phone:409-550-8991
Mailing Address - Street 1:550 IH 10 S
Mailing Address - Street 2:205
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-4017
Mailing Address - Country:US
Mailing Address - Phone:409-550-8991
Mailing Address - Fax:713-341-9074
Practice Address - Street 1:550 IH 10 S
Practice Address - Street 2:205
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-4017
Practice Address - Country:US
Practice Address - Phone:409-550-8991
Practice Address - Fax:713-341-9074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health