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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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