Provider Demographics
NPI:1144456716
Name:NIGHTINGALE STAFFING, INC.
Entity type:Organization
Organization Name:NIGHTINGALE STAFFING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:C
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:912-355-6472
Mailing Address - Street 1:4402 LAWRENCEVILLE RD STE 216
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-2629
Mailing Address - Country:US
Mailing Address - Phone:877-556-5152
Mailing Address - Fax:770-446-5081
Practice Address - Street 1:9100 WHITE BLUFF RD STE 301
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-4670
Practice Address - Country:US
Practice Address - Phone:800-620-5161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA029R0016251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000407965SMedicaid
GA000407965XMedicaid