Provider Demographics
NPI:1538764816
Name:MERIDIANA HEALTH LLC
Entity type:Organization
Organization Name:MERIDIANA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHNSON
Authorized Official - Middle Name:
Authorized Official - Last Name:DUQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-841-3542
Mailing Address - Street 1:10107 MACLAREN DR
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-1770
Mailing Address - Country:US
Mailing Address - Phone:346-816-7683
Mailing Address - Fax:346-816-7691
Practice Address - Street 1:10107 MACLAREN DR
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-1770
Practice Address - Country:US
Practice Address - Phone:468-167-6833
Practice Address - Fax:346-816-7691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-03
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health