Provider Demographics
NPI:1649220658
Name:MERRYMAN HOME HEALTH, INC.
Entity Type:Organization
Organization Name:MERRYMAN HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN,ADMIN,OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-828-1173
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TX
Mailing Address - Zip Code:77856-0247
Mailing Address - Country:US
Mailing Address - Phone:979-828-1173
Mailing Address - Fax:979-828-3426
Practice Address - Street 1:100 DECHERD
Practice Address - Street 2:STE B
Practice Address - City:FRANKLIN
Practice Address - State:TX
Practice Address - Zip Code:77856-4998
Practice Address - Country:US
Practice Address - Phone:979-828-1173
Practice Address - Fax:979-828-3426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010271251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679536Medicare Oscar/Certification
TX679536Medicare UPIN