MEDICARE: MARSHALL'S HOME HEALTH AIDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	233172	FL

General Provider Information

NPI Number	:	1659708535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARSHALL'S HOME HEALTH AIDE

Provider Business Mailing Address
First Line	:	10331 PALMETTO BAY RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-9159
Country	:	US
Telephone Number	:	904-343-0695
Fax Number	:	904-738-7246

Provider Business Practice Location Address
First Line	:	10331 PALMETTO BAY RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-9159
Country	:	US
Telephone Number	:	904-343-0695
Fax Number	:	904-738-7246

Authorized Official
Title or Position	:	CEO
Name	:	ROSALUND RENEE MARSHALL
Credential	:
Telephone Number	:	904-343-0695

Provider Enumeration Date	:	10/09/2013
Last Update Date	:	10/09/2013

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