Provider Demographics
NPI:1629198874
Name:MARSHALL NURSING SERVICES, INC
Entity Type:Organization
Organization Name:MARSHALL NURSING SERVICES, INC
Other - Org Name:MARSHALL HEALTHCARE & CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:CYR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-786-3554
Mailing Address - Street 1:9 BEAL ST
Mailing Address - Street 2:
Mailing Address - City:MACHIAS
Mailing Address - State:ME
Mailing Address - Zip Code:04654-1002
Mailing Address - Country:US
Mailing Address - Phone:207-255-3387
Mailing Address - Fax:207-255-3320
Practice Address - Street 1:179 LISBON ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7248
Practice Address - Country:US
Practice Address - Phone:207-786-3554
Practice Address - Fax:207-786-8507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2059314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME20-5109Medicare ID - Type UnspecifiedMEDICARE PROV NUMBER