Provider Demographics
NPI:1720681141
Name:MCCOY, MARCIE
Entity Type:Individual
Prefix:
First Name:MARCIE
Middle Name:
Last Name:MCCOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8912 ROCK HILL RD NW
Mailing Address - Street 2:
Mailing Address - City:STRASBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44680-8915
Mailing Address - Country:US
Mailing Address - Phone:330-340-3801
Mailing Address - Fax:
Practice Address - Street 1:5561 PIPERS MEADOW DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-3263
Practice Address - Country:US
Practice Address - Phone:330-340-3801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant