Provider Demographics
NPI:1326803594
Name:MARBECK SERVICES LLC
Entity Type:Organization
Organization Name:MARBECK SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHELMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:234-804-2944
Mailing Address - Street 1:2617 BLAKE AVE NW APT 15
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3451
Mailing Address - Country:US
Mailing Address - Phone:234-804-2944
Mailing Address - Fax:
Practice Address - Street 1:2617 BLAKE AVE NW APT 15
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-3451
Practice Address - Country:US
Practice Address - Phone:234-804-2944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health