Provider Demographics
NPI:1447665096
Name:MARSHALL'S HOME HEALTH AIDE
Entity type:Organization
Organization Name:MARSHALL'S HOME HEALTH AIDE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ROSALIND
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-438-2379
Mailing Address - Street 1:4600 TOUCHTON RD E
Mailing Address - Street 2:BUILDING 100 SUITE 150
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-8299
Mailing Address - Country:US
Mailing Address - Phone:904-438-2379
Mailing Address - Fax:904-738-7246
Practice Address - Street 1:4600 TOUCHTON RD E
Practice Address - Street 2:BUILDING 100 SUITE 150
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-8299
Practice Address - Country:US
Practice Address - Phone:904-438-2379
Practice Address - Fax:904-738-7246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL233172251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health