Provider Demographics
NPI:1265180491
Name:STEADFAST ASSISTING LLC
Entity type:Organization
Organization Name:STEADFAST ASSISTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARIC
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:202-420-9459
Mailing Address - Street 1:4955 MOORHEAD AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-5546
Mailing Address - Country:US
Mailing Address - Phone:202-420-4959
Mailing Address - Fax:
Practice Address - Street 1:4955 MOORHEAD AVE APT 2
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-5546
Practice Address - Country:US
Practice Address - Phone:202-420-9459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty