Provider Demographics
NPI:1780901454
Name:MCMAHAN NURSING, LLC
Entity type:Organization
Organization Name:MCMAHAN NURSING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHONA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:732-421-6561
Mailing Address - Street 1:2207 TIMBER RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-3133
Mailing Address - Country:US
Mailing Address - Phone:732-421-6561
Mailing Address - Fax:732-727-1788
Practice Address - Street 1:2207 TIMBER RIDGE CT
Practice Address - Street 2:
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859-3133
Practice Address - Country:US
Practice Address - Phone:732-421-6561
Practice Address - Fax:732-727-1788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO10699700251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health