Provider Demographics
NPI:1770136327
Name:MECA HOME HEALTH LLC
Entity type:Organization
Organization Name:MECA HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNGIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-494-3986
Mailing Address - Street 1:3058 ROLLINS CT
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9776
Mailing Address - Country:US
Mailing Address - Phone:843-494-3986
Mailing Address - Fax:
Practice Address - Street 1:3058 ROLLINS CT
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9776
Practice Address - Country:US
Practice Address - Phone:843-494-3986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care