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Organization
STAFF MEDICAL SERVICE HOME HEALTH, INC
Active
Organization
STAFF MEDICAL SERVICE HOME HEALTH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RUBY STOCKDALE (PRESIDENT OF BOARD OF DIRECTORS)
(256) 405-4022
Entity
Organization
Contact information
Practice address
1200 NOBLE ST, SUITE101, ANNISTON, AL 36201-4659
(256) 405-4022
(256) 365-2060
Mailing address
1200 NOBLE ST, SUITE101, ANNISTON, AL 36201-4659
(256) 405-4022
(256) 365-2060
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
3943
AL
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
AL
385HR2065X
Child Physical Disabilities Respite Care
—
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04111912
MEDICAID WAVER
AL
Enumeration date
09/08/2011
Last updated
07/21/2022
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