Provider Demographics
NPI:1629390091
Name:MARIMART HEALTH CARE PLUS LLC
Entity Type:Organization
Organization Name:MARIMART HEALTH CARE PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIAMA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SISAY -JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-470-9755
Mailing Address - Street 1:208 W JOHNSTOWN RD
Mailing Address - Street 2:STE
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-2731
Mailing Address - Country:US
Mailing Address - Phone:614-470-9755
Mailing Address - Fax:
Practice Address - Street 1:208 W JOHNSTOWN RD
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-2731
Practice Address - Country:US
Practice Address - Phone:614-470-9755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health