Provider Demographics
NPI:1437106184
Name:MELICARE INC
Entity Type:Organization
Organization Name:MELICARE INC
Other - Org Name:NATIONAL HOMECARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WHITWORTH
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:225-262-7770
Mailing Address - Street 1:16146 GREENWELL SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:GREENWELL SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70739-4118
Mailing Address - Country:US
Mailing Address - Phone:225-262-7770
Mailing Address - Fax:225-262-7772
Practice Address - Street 1:2615 E END BLVD S
Practice Address - Street 2:SUITE 300
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75672-7425
Practice Address - Country:US
Practice Address - Phone:903-938-5858
Practice Address - Fax:903-938-5859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008627251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX67-9432Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER