Provider Demographics
NPI:1831872001
Name:BOSS HEALTH LLC
Entity type:Organization
Organization Name:BOSS HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:301-988-7822
Mailing Address - Street 1:10627 CRYSTAL FALLS DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-9732
Mailing Address - Country:US
Mailing Address - Phone:301-988-7822
Mailing Address - Fax:539-800-2158
Practice Address - Street 1:10627 CRYSTAL FALLS DR
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-9732
Practice Address - Country:US
Practice Address - Phone:301-988-7822
Practice Address - Fax:539-800-2158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No253Z00000XAgenciesIn Home Supportive Care