Provider Demographics
NPI:1205363355
Name:MERRIMENT HOME HEALTHCARE, LLC
Entity Type:Organization
Organization Name:MERRIMENT HOME HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:EHTESHAM
Authorized Official - Middle Name:EDDIN
Authorized Official - Last Name:ANSARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-506-1996
Mailing Address - Street 1:329 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-5804
Mailing Address - Country:US
Mailing Address - Phone:201-487-1779
Mailing Address - Fax:201-487-1780
Practice Address - Street 1:329 MAIN ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-5804
Practice Address - Country:US
Practice Address - Phone:201-487-1779
Practice Address - Fax:201-487-1780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health