Provider Demographics
NPI:1417974296
Name:MARSHALL COUNTY HOME HEALTH INC.
Entity Type:Organization
Organization Name:MARSHALL COUNTY HOME HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:GOEDECKE
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:903-564-7709
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:MADILL
Mailing Address - State:OK
Mailing Address - Zip Code:73446-0278
Mailing Address - Country:US
Mailing Address - Phone:580-795-9992
Mailing Address - Fax:580-795-7609
Practice Address - Street 1:301 W LILLIE BLVD
Practice Address - Street 2:
Practice Address - City:MADILL
Practice Address - State:OK
Practice Address - Zip Code:73446-1253
Practice Address - Country:US
Practice Address - Phone:580-795-9992
Practice Address - Fax:580-795-7609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7016251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100261140AMedicaid