Provider Demographics
NPI:1881140994
Name:EDNAMARIE HOME CARE LLC
Entity type:Organization
Organization Name:EDNAMARIE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAFFOE BONNIE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:443-929-6930
Mailing Address - Street 1:4700 DARK STAR WAY
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4743
Mailing Address - Country:US
Mailing Address - Phone:215-880-7421
Mailing Address - Fax:
Practice Address - Street 1:4700 DARK STAR WAY
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4743
Practice Address - Country:US
Practice Address - Phone:215-880-7421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR205810251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management