Provider Demographics
NPI:1144524406
Name:MELINDA ANDERSON
Entity type:Organization
Organization Name:MELINDA ANDERSON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:903-893-6007
Mailing Address - Street 1:2624 N LOY LAKE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2515
Mailing Address - Country:US
Mailing Address - Phone:903-893-6007
Mailing Address - Fax:
Practice Address - Street 1:2624 N LOY LAKE RD
Practice Address - Street 2:SUITE B
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2515
Practice Address - Country:US
Practice Address - Phone:903-893-6007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care