Provider Demographics
NPI:1912206939
Name:EPIC MEDICAL STAFFING, LLC
Entity Type:Organization
Organization Name:EPIC MEDICAL STAFFING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-359-7920
Mailing Address - Street 1:1800 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:LAKE COMO
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-2931
Mailing Address - Country:US
Mailing Address - Phone:732-359-7920
Mailing Address - Fax:732-359-7921
Practice Address - Street 1:1800 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:LAKE COMO
Practice Address - State:NJ
Practice Address - Zip Code:07719-2931
Practice Address - Country:US
Practice Address - Phone:732-359-7920
Practice Address - Fax:732-359-7921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-16
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHPO0143300251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health