Provider Demographics
NPI:1700495603
Name:KRISTIE E. MARKS ENTERPRISES INC.
Entity Type:Organization
Organization Name:KRISTIE E. MARKS ENTERPRISES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-907-4249
Mailing Address - Street 1:3637 MEDINA RD STE 20
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8155
Mailing Address - Country:US
Mailing Address - Phone:330-907-4249
Mailing Address - Fax:
Practice Address - Street 1:3637 MEDINA RD STE 20
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8155
Practice Address - Country:US
Practice Address - Phone:330-907-4249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health