Provider Demographics
NPI:1992010904
Name:MERIDIAN LTC LTD
Entity Type:Organization
Organization Name:MERIDIAN LTC LTD
Other - Org Name:APEX SECURE CARE BROWNFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONNALD
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:JEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LNFA
Authorized Official - Phone:806-637-7561
Mailing Address - Street 1:1101 E LAKE ST
Mailing Address - Street 2:
Mailing Address - City:BROWNFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:79316-3811
Mailing Address - Country:US
Mailing Address - Phone:806-637-7561
Mailing Address - Fax:806-637-2637
Practice Address - Street 1:1101 E LAKE ST
Practice Address - Street 2:
Practice Address - City:BROWNFIELD
Practice Address - State:TX
Practice Address - Zip Code:79316-3811
Practice Address - Country:US
Practice Address - Phone:806-637-7561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility