Provider Demographics
NPI:1134690431
Name:MERRY HOME HEALTH CARE LL C
Entity Type:Organization
Organization Name:MERRY HOME HEALTH CARE LL C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FOWZIA
Authorized Official - Middle Name:H M
Authorized Official - Last Name:ESSE
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:703-597-2175
Mailing Address - Street 1:6000 STEVENSON AVE STE G
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-3563
Mailing Address - Country:US
Mailing Address - Phone:703-370-1980
Mailing Address - Fax:703-212-7236
Practice Address - Street 1:6000 STEVENSON AVE STE G
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-3563
Practice Address - Country:US
Practice Address - Phone:703-370-1980
Practice Address - Fax:703-212-7236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-11
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care