MEDICARE: DAVID E MARSHALL ENTERPRISES INC

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	343900000X	Non-emergency Medical Transport (VAN)	M624165780300	FL
2	385H00000X	Respite Care	001649600	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5277-6-GA	OTHER		GROUP HOME
2	39966418	OTHER	FL	HOMEMAKER CHOMPANION AGENCY
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952766461
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID E MARSHALL ENTERPRISES INC

Provider Business Mailing Address
First Line	:	2417 ROANOKE SPRINGS DR
Second Line	:
City	:	RUSKIN
State	:	FL
Zip	:	33570-6335
Country	:	US
Telephone Number	:	813-416-6237
Fax Number	:	888-415-7176

Provider Business Practice Location Address
First Line	:	2417 ROANOKE SPRINGS DR
Second Line	:
City	:	RUSKIN
State	:	FL
Zip	:	33570-6335
Country	:	US
Telephone Number	:	813-416-6237
Fax Number	:	888-415-7176

Authorized Official
Title or Position	:	CEO
Name	:	DAVID E MARSHALL
Credential	:	PRESIDENT
Telephone Number	:	813-416-6237

Provider Enumeration Date	:	12/28/2015
Last Update Date	:	12/28/2015

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