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General NPI Number Information
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NPI Number | 1952565624
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Entity Type | Organization
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Legal Business Name | MARSHALL SENIOR CARE LLC
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 1007 S WASHINGTON AVE
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City | MARSHALL
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State | TX
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Zip | 75670-5333
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Country | US
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Telephone | 903-935-7971
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Fax | 903-935-1908
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Provider Business Mailing Address
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Address Line | 1007 S WASHINGTON AVE
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City | MARSHALL
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State | TX
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Zip | 75670-5333
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Country | US
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Telephone | 903-935-7971
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Fax | 903-935-1908
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. LINDA K. BENSON
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Credential | RN
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Telephone | 903-935-7971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number | 120459
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 120459
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 120459
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License Number State | TX
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