Provider Demographics
NPI:1861200644
Name:ST MEDICAL NURSING SERVICES
Entity type:Organization
Organization Name:ST MEDICAL NURSING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTHCARE PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:TISDALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-468-7834
Mailing Address - Street 1:1122 VERNON ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-2142
Mailing Address - Country:US
Mailing Address - Phone:800-468-7834
Mailing Address - Fax:800-468-7834
Practice Address - Street 1:1513 S WASHINGTON AVE APT B
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-2145
Practice Address - Country:US
Practice Address - Phone:800-468-7834
Practice Address - Fax:800-468-7834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-25
Last Update Date:2024-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No342000000XTransportation ServicesTransportation Network Company
No385H00000XRespite Care FacilityRespite Care
No174200000XOther Service ProvidersMeals
No253Z00000XAgenciesIn Home Supportive Care