=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851208813
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARILYNS KITCHEN LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/26/2026
-----------------------------------------------------
Last Update Date | 08/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5600 RIVERS AVE
-----------------------------------------------------
City | NORTH CHARLESTON
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29406-6027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-992-5719
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 103 DAVIDSON DR
-----------------------------------------------------
City | LADSON
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29456-3307
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-992-5719
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | NIKEVA MEGAN MCPHERSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 404-992-5719
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332U00000X
-----------------------------------------------------
Taxonomy Name | Home Delivered Meals
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------