Provider Demographics
NPI:1376819060
Name:MERCIMEE HEALTH CARE SERVICE
Entity Type:Organization
Organization Name:MERCIMEE HEALTH CARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:BOONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-984-7817
Mailing Address - Street 1:312 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4682
Mailing Address - Country:US
Mailing Address - Phone:732-688-5876
Mailing Address - Fax:732-984-7817
Practice Address - Street 1:312 MYRTLE AVE APT 203
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4685
Practice Address - Country:US
Practice Address - Phone:732-688-5876
Practice Address - Fax:732-984-7817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0001084251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health