Provider Demographics
NPI:1619382884
Name:MASSIVE MEDICAL STAFFING LLC
Entity type:Organization
Organization Name:MASSIVE MEDICAL STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANNISHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROWNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-497-2517
Mailing Address - Street 1:1524 JOHN B WHITE BLVD
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301
Mailing Address - Country:US
Mailing Address - Phone:864-497-2517
Mailing Address - Fax:331-625-8584
Practice Address - Street 1:1524 JOHN B WHITE SR BLVD
Practice Address - Street 2:SUITE 2C
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-3878
Practice Address - Country:US
Practice Address - Phone:864-497-2517
Practice Address - Fax:331-625-8584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health