Provider Demographics
NPI:1801242565
Name:MERIDIAN HOMECARE LLC
Entity type:Organization
Organization Name:MERIDIAN HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:MAINA
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:972-697-8047
Mailing Address - Street 1:4825 WORTHING DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-7636
Mailing Address - Country:US
Mailing Address - Phone:972-697-8047
Mailing Address - Fax:
Practice Address - Street 1:4825 WORTHING DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-7636
Practice Address - Country:US
Practice Address - Phone:972-697-8047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care